- The Cigna Group (Bloomfield, CT)
- …liaises with Matrix Partners, as required, to develop and promote shared goals. The Quality Review and Audit Senior Analyst position recognizes experience in ... Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis program. Responsible for liaising with the… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview** Reporting to the Manager, the ** Senior Data and Quality Analyst** will be part of our provider network compliance and reporting team. You will ... Lead Analyst on the team, proofs work of Data Quality and Audit Analysts, and also trains...Must have previous experience working with healthcare data or claims data + Bachelor's Degree OR In lieu of… more
- Axis (Alpharetta, GA)
- …available upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims...Assurance - Comply with best practices measured by monthly Quality Assurance and Management Initiated Audit scores… more
- Point32Health (Canton, MA)
- …service to our members, partners, colleagues and communities. **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of ... to everyone in our communities. At Point32Health, we are building on the quality , nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard… more
- Houston Methodist (Houston, TX)
- …risk and identify and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of ... specific practices. Serves a subject matter expert. + Effectively communicates audit results to faculty and staff. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS**… more
- CHS (Clearwater, FL)
- …for Claims Department strategy, planning, staffing projection, budgeting and quality assurance and improvement. * Responsibility for final hiring decisions on ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...Quality to implement appropriate standards for accuracy and audit procedures intended to validate those standards are met.… more
- WTW (Chicago, IL)
- **Description** As a Lead Auditor you will apply your audit , project management and client management skills to lead client audits. You will serve as the team leader ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more
- American Water (Camden, NJ)
- …wastewater services to our communities. Effective, efficient, and intelligent insurance claims management, oversight, and forecasting are essential to this mission. ... As the Claims & Insurance Manager, you will be instrumental in...are not limited to: o Compliance with applicable Internal Audit , Sarbanes-Oxley mandates and other internal policies. o Monopolistic… more
- AIG (Atlanta, GA)
- Join us as a Senior Claims Adjuster to take on...to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes , ... key responsibilities within a world - class claims function. Make your mark in Claims ...claims expert and thought leader. + As a senior member of the team , you will act… more
- Commonwealth Care Alliance (Boston, MA)
- …not be considered at this time._** Position Summary: Working under the direction of the SVP Claims , the Senior Data Analyst - Payment Integrity & Claims will ... 011250 CCA- Claims **_This position is available to remote employees...to support organizational decision-making, and identify opportunities to improve quality and control costs. Supervision Exercised: * No, this… more
- Healthfirst (NY)
- …+ Assists in the development of strategic plans to ensure modern and efficient claims processing across the entire lifecycle with a focus on a unified, streamlined ... the evolution and operation of a variety of digital claims capabilities on our modernization roadmap + Analyzes project...functions + Ensures all NY state and federal compliance, audit and regulatory requirements are met + Performs other… more
- Independent Health (Buffalo, NY)
- …knowledge and audit tips across the team. The Clinical & Coding Specialist- Senior will support the leadership in Hospital Audit in accomplishing all aspects ... fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist- Senior will be responsible for reviewing coding and clinical decisions on… more
- Marotta Controls, Inc. (Chaska, MN)
- …a company where your work supports a mission that makes a difference-apply today ! Senior Quality Manager Overview: The Quality Manager - Electric Motors is ... Controls, a New Jersey Top Workplace three years running! Dedicated to innovation, quality and excellence, we deliver cutting edge control systems for the Aerospace… more
- Tucson Electric Power (Tucson, AZ)
- **Benefits Analyst - I, II, Senior or Lead** Company **Tucson Electric Power** Location **Tucson, AZ** Requisition ID **6015** **About Us** UNS Energy Corporation ... We embrace a spirit of giving, dedicated to improving quality of life in the communities we have served.... **Job Description - Benefits Analyst - I, II, Senior or Lead** **Position Overview** The Benefits Analyst is… more
- Ventura County (Ventura, CA)
- Accountant I/II/ Senior Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4690309) Apply Accountant I/II/ Senior Salary $61,637.06 - ... Ventura County's beauty and weather combined with a wonderful quality of life are among the many reasons our...or under direction, performs full range (II) to complex ( Senior ) accounting duties in assigned fiscal program areas; functional… more
- RWJBarnabas Health (West Orange, NJ)
- Senior Counsel, Assistant Vice President of Legal Affairs, Grants, Funding & Regulatory ComplianceReq #:0000206243 Category:Professional / Management ... Location: 95 Old Short Hills Road, West Orange, NJ 07052 Job Title: Senior Counsel Location:SBC Corporation Department Name: General Counsel Office Req #:0000206243… more
- Snapsheet (Chicago, IL)
- Job Title: Senior Software Engineer - R&D Company: Snapsheet Job Location: USA, Remote Job Type: Full-time, direct hire Job Department: Technology Team : R&D About ... Snapsheet: Snapsheet exists to simplify claims . We leverage our expertise in virtual estimating and...all sizes. About the role: We're looking for a Senior Software Engineer to join our growing R&D team… more
- Ventura County (Ventura, CA)
- Senior /Principal Accountant-MB Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4946844) Apply Senior /Principal Accountant-MB Salary ... Insurance, Tuition Reimbursement, Wellness Program. THE POSITION Under direction ( Senior Accountant-MB) or general direction (Principal Accountant-MB), plans, leads,… more
- The Cigna Group (Plano, TX)
- …and data informatics and data exchange using healthcare and clinical data such as Claims , Membership, Audit , Client Structure, and Benefits. If you will be ... job profile for this position is Data Management Strategy Senior Advisor, which is a Band 4 Senior...system analysis, and data retention processes to assure data quality standards. + Collaborate with other departments to ensure… more
- CVS Health (Irving, TX)
- …an exciting opportunity to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives to ... a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and...reporting using SQL and SAS. You will continuously improve quality controls and accuracy of reported data, looking for… more