- CVS Health (Albany, NY)
- …solutions to make health care more personal, convenient and affordable. Position Summary laim Audit Quality Analysts need to have a wide depth and breadth of ... of detail and review.A candidate must become subject matter experts in claims , plan documents, eligibility, coverages, and quirks of multiple groups. Knowledge in… more
- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Claims Specialist , you will work with internal teams to provide cutting-edge solutions that will directly ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...clinical, and other data insights that directly improve the quality and efficiency of patient care. At LogixHealth, we're… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and audit ... with Home Health operations and customers to drive improvement in the quality of services delivered to patients. Responsibilities + Code diagnosis accurately… more
- Burrell Behavioral Health (Springfield, MO)
- …Join our mission to deliver exceptional healthcare services with integrity. As a Compliance Audit Specialist , you will play a vital role in ensuring our ... to offer while pursuing a rewarding career with our organization. The Compliance Audit Specialist position offers + All-Inclusive Employee Benefits Package - A… more
- Generac Power Systems (Waukesha, WI)
- …of mind through reliable products and exceptional support. The Warranty Quality Specialist is responsible for monitoring warranty claim rates and supporting ... **Warranty Quality Specialist ** **Company** Generac Power Systems...Duties:** + Analysis of warranty information and processing warranty claims per warranty guidelines + Conduct warranty claim… more
- Beth Israel Lahey Health (Burlington, MA)
- …and accurately appeal claims to ensure successful initial submission. The Billing Specialist will be responsible for charge and claim review to ensure the ... **Work Shift:** Day (United States of America) The Billing Specialist role specializes in high dollar claims ,...claim and it was billed appropriately. The Billing Specialist will work directly with Supervisors and Managers to… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …to recovery and repayment of inappropriate payments discovered as a result of claims audit or investigation. + Maintains awareness of regulations and current ... Coordinates periodic review and analysis of Bon Secours Mercy Health provider claims denial reports, operational assessment reports, internal quality control… more
- Beth Israel Lahey Health (Burlington, MA)
- …and maintains open communication with third party payor representatives in order to resolve claims issues. 4. Reviews claim forms for the accuracy of procedures, ... provider documentation in order to determine appropriate coding and initiate corrected claims and appeals. Duties include hands on coding, documentation review and… more
- CVS Health (Phoenix, AZ)
- …- Executes both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision, referring deviations from standard ... effective and timely support. - Acts as a subject matter expert on Quality Specialist workflows, policies, systems requirements, and enhancements as well as… more
- Medical Mutual of Ohio (OH)
- …to software quality assurance and testing. . Strong knowledge of claims adjudication systems and processes. . Strong analytical and problem-solving skills with ... of training and experience. . 2 years' experience as a Business Systems Specialist or equivalent experience with software quality assurance and testing. .… more
- Beth Israel Lahey Health (Burlington, MA)
- …and maintains open communication with third party payor representatives in order to resolve claims issues. 5. Reviews claim forms for the accuracy of procedures, ... and interprets third party payments, adjustments and denials. Initiates corrected claims , appeals and analyzes unresolved third party and self-pay accounts,… more
- Beth Israel Lahey Health (Charlestown, MA)
- …and maintains open communication with third party payor representatives in order to resolve claims issues. 5) Reviews claim forms for the accuracy of procedures, ... and interprets third party payments, adjustments and denials. Initiates corrected claims , appeals and analyzes unresolved third party and self-pay accounts,… more
- Heritage Ministries (Gerry, NY)
- …do. Heritage Ministries is in growth mode and currently seeking an Accounts Receivable Specialist to support the delivery of quality services and the financial ... of the organization by ensuring accurate billing, timely Submission of claims , monitoring claim status, researching rejections and Denials, documenting… more
- UIC Government Services and the Bowhead Family of Companies (Dayton, OH)
- **Overview** FISCAM BUSINESS SPECIALIST (AFSAC): Bowhead seeks a FISCAM Business Specialist to support the AFSAC contract located in Dayton, OH. This position ... Assistance Command (AFSAC). This includes providing Federal Information System Controls Audit Manual (FISCAM) knowledge and supporting the preparation of AFSAC's key… more
- Burrell Behavioral Health (Kirksville, MO)
- …financial records? Join our team at Preferred Family Healthcare as a Billing Specialist ! In this role, you'll oversee the in-house database, ensure accuracy of ... various departments to streamline billing processes. As a Billing Specialist , you'll be responsible for maintaining accurate billing records,...Kirksville is a community driven hub with a high quality of life. Join us in making a difference… more
- Air National Guard Units (Duluth, MN)
- …MEMBERSHIP IS REQUIRED Responsibilities Major Duties: This is not an all-inclusive list A QUALITY ASSURANCE SPECIALIST , GS, 1910, 11, The primary purpose of this ... the maintenance organization designed to assist maintenance managers. Serves as the Quality Assurance Specialist (QAS) for the planning, implementation and… more
- New York State Civil Service (Albany, NY)
- …Agency Medicaid Inspector General, NYS Office of the Title Program Research Specialist 2 Occupational Category Other Professional Careers Salary Grade 23 Bargaining ... service, or 55 b/c service as a Medicaid Integrity Specialist 1; OR current New York State employee with...on all scheduled RAC recovery work; record and track quality metrics concerning these recoveries as well as the… more
- Houston Methodist (Katy, TX)
- …and the CBO team to ensure timely compliance with and completion of audit or data requests. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS** + Assists management in ... **. (Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with Houston Methodist's Corporate Central… more
- Loretto Management Corporation (Syracuse, NY)
- …supervision of the Health Information Director/Designee, the Compliance Reimbursement Specialist is responsible for analyzing documented clinical data to identify ... the patient's clinical picture, severity of illness, etc. In addition, the Specialist will identify, collect, assess, monitor and review documentation and encounter… more
- Ferrotec USA (Bedford, NH)
- …to proudly provide pure precision solutions to our customers, delivering superior quality , value, and service. Ferrotec (USA) Corporation is a technology company ... AN IMPACT This position is responsible for researching and preparing duty drawback claims . This position will also assist in creating new operating procedures and… more