- Commonwealth Care Alliance (Boston, MA)
- …**Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance , the Claims Sr. Analyst plays a critical role in ensuring ... Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance ,...reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject… more
- Donegal Insurance Group (Marietta, PA)
- …Group has an opening for a Business Analyst / Quality Assurance Analyst . As a member of our Claims team, this position collaborates with business users ... of functionality is achieved + Provides daily support for Claims business units including providing technical guidance, troubleshooting software...+ 3 years of Business Analyst and/or Quality Assurance Analyst experience with… more
- Cognizant (Cheyenne, WY)
- **About the role** As a ** Quality Assurance Analyst - Healthcare Systems** , you will make an impact by ensuring data integrity, validating business rules, ... of EDI X12 837 and 835 transaction sets for claims processing. + Ability to write and execute detailed...platforms such as FACETS. + Familiarity with mocking 837 claims for testing multiple claim scenarios. + Exposure to… more
- WTW (Miami, FL)
- …+ Maintain strong professional relationships with key parties to facilitate efficient claims resolution. **Compliance & Quality Assurance ** + Ensure ... We are seeking a highly motivated individual to join our Company as a Claims Analyst based in Miami. The candidate will have multiple claims responsibilities… more
- NJM Insurance (Trenton, NJ)
- …(WC) Training and Quality Assurance Management Supervisor, the WC Quality Assurance /Compliance Analyst is responsible for ensuring adherence to state ... training team to develop resources and training material to support regulatory and Quality Assurance compliance + Attend internal and external QA and Compliance… more
- CGI Technologies and Solutions, Inc. (Indianapolis, IN)
- ** Quality Analyst ** **Category:** Testing/ Quality Assurance **Main location:** United States, Indiana, Indianapolis **Position ID:** J0825-0830 ... . **Position Description:** CGI is looking for a skilled Quality Analyst for data testing across insurance...Expectations, Soda, or custom Python/SQL test harnesses to automate quality assurance processes. * Validate data migration… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …management (RHIA or RHIT) or a Nursing Degree. . Three (3) years' experience in claims auditing, quality assurance , or recovery auditing, of (MS/APR) DRG ... Summary: The Payment Integrity DRG Coding & Clinical Validation Analyst position has an extensive background in acute facility-based...Level I Qualifications) . Five (5) years' experience in claims auditing, quality assurance , or… more
- State of Colorado (Denver, CO)
- FAMLI Quality Assurance - Program Assistant II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5141505) Apply FAMLI Quality ... $4,906.00 - $6,937.20 Monthly $58,872.00 - $83,246.40 Annually The Quality Assurance unit promotes and ensures the...accounts, and specific determinations and actions taken on FAMLI claims and employer accounts to ensure rules and standards… more
- Center For Health Information And Analysis (Boston, MA)
- …in a dynamic, mission-driven environment. + Champion Data Integrity: Participate in quality assurance (QA) and documentation processes to ensure that reported ... development of data-driven policies that aim to improve the quality and equity of care, while keeping costs affordable...in health policy impact! We are seeking a Research Analyst to contribute to our growing research projects within… more
- Fifth Third Bank, NA (Grand Rapids, MI)
- …of accuracy in dispute filings and documentation, measured through internal audits and quality assurance reviews. + Conformance: Adhere to the provided daily ... with Uniform Commercial Code (UCC) and Regulation E and Regulation Z claims . The Analyst uses various bank and vendor systems to research questions regarding the… more
- NTT DATA North America (Raleigh, NC)
- …and maintain custom reports and dashboards, and assist with data validation and quality assurance . Minimum Qualifications Bachelor's degree in a relevant field ... apply now. We are currently seeking a Business Systems Analyst - EPIC to join our team in Durham,...tools, especially related to critical payer data like eligibility, claims , and membership. Key Responsibilities System Analysis and Design:… more
- The County of Los Angeles (Los Angeles, CA)
- …and systems implementation tools, techniques and methodologies, as needed. Establishes quality assurance procedures, as needed. Supervises lower level technical ... PRINCIPAL INFORMATION SYSTEMS ANALYST / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4678895) Apply … more
- Houston Methodist (Houston, TX)
- …risk and identify and capture potential revenue opportunities. This position performs quality assurance , detailed claims analysis, and medical record ... are being billed to patients and third-party payers. Performs quality assurance . **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Proactively stays up-to-date… more
- BrightView (Blue Bell, PA)
- …team where you can grow to be your brightest. We're looking for a Quality Assurance Analyst . Can you picture yourself here? **Hybrid Schedule:** ... Agency Resumes At This Time **Job Summary** + The Claims Manager is a key leader in the Risk...with a focus on large claim volumes and consistent quality + Monitor and guide Third-Party Administrator (TPA) performance,… more
- Terumo Medical Corporation (Somerset, NJ)
- …forwarding of customer complaints (ie adverse events, product performance reports, etc.) to Quality Assurance (QA), and by ensuring all promotional messaging (ie ... Contract Analyst , Temp Date: Nov 19, 2025 Req ID:...involve the sale of Terumo product, to ensure high quality contracts that are effective, equitable and compliant. The… more
- HCA Healthcare (Nashville, TN)
- …and resolving issues + Assists with developing, and monitoring adherence to, quality assurance standards + Assists manager with implementation and monitoring ... colleagues invested over 156,000 hours volunteering in our communities. As a Payment Compliance Analyst with Parallon you can be a part of an organization that is… more
- Genesis Healthcare (Roosevelt, NY)
- …and audit functions and investigations. 5. Participates, as requested, in quality assurance and process improvement activities. Responsibilities A Licensed ... and possible career growth opportunities. POSITION SUMMARY: The Licensed Behavior Analyst will provide services designed to facilitate improved behavior and skill… more
- Molina Healthcare (AZ)
- …+ Creating and executing comprehensive test plans + Ongoing pricer maintenance, quality assurance , and compliance with deployment activities. + Interpret release ... **Job Description** **Job Summary** The Lead Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and… more
- Humana (Nashville, TN)
- …+ Creating and executing comprehensive test plans + Ongoing Medicare Pricer maintenance, quality assurance , and compliance + Determine root causes driving issues ... health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer...closely with IT, the pricing software vendor, CIS BSS, claims operations, and other business teams involved in the… more
- Point32Health (FL)
- …is compliant with the regulatory requirements set-forth by NCQA (National Committee for Quality Assurance ), DOI (Dept of Insurance), CMS, DOL and any state ... leading not-for-profit health and well-being organization dedicated to delivering high- quality , affordable healthcare. Serving nearly 2 million members, Point32Health… more
Related Job Searches:
Analyst,
Assurance,
Assurance Analyst,
Claims,
Claims Analyst,
Claims Quality,
Quality,
Quality Analyst,
Quality Assurance,
Quality Assurance Analyst