• Complex Claims Director, Severity

    AIG (Atlanta, GA)
    …+ You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes , ensuring mitigation of ... Join us as a Senior Claims Adjuster to take on key responsibilities within a world - class claims function. Make your mark in Claims Our Claims teams are… more
    AIG (03/08/25)
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  • Quality Assurance Internal…

    FM (Johnston, RI)
    …and outcomes - Internal audit strategic planning and management - Quality Assurance and Improvement Plan (QAIP) -Strong project and change management ... Audit , Engineering Audit , Client Service Audit , Claims Audit etc.) including...a criteria per policy.** * Develop and maintain the Quality Assurance and Improvement Program framework, which… more
    FM (04/06/25)
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  • Claim Analyst IV (Lexington), Professional…

    AIG (Boston, MA)
    …You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes, ensuring mitigation of indemnity ... Join us as a Claims Analyst IV to take on key responsibilities within a world-class claims function. Make your mark in Claims As a Claim Analyst IV, you will… more
    AIG (03/15/25)
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  • AVP, Quality Assurance & Operational…

    UPMC (Pittsburgh, PA)
    …; and audit management, support and facilitation teams. The AVP, Quality Assurance & Operational Integrity evaluates statistical patterns and trends of ... + Develops, assesses, and adapts clear and effective Quality Assurance monitoring, audits/reviews, testing, reporting, and audit sampling methodologies to… more
    UPMC (04/28/25)
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  • Claims Quality Supervisor

    UCLA Health (Los Angeles, CA)
    …a detail-oriented and experienced Claims Quality Supervisor to lead our audit and quality assurance initiatives across all aspects of claims ... regulatory requirements. Key responsibilities include: + Developing and implementing internal quality assurance monitoring systems and reporting tools. +… more
    UCLA Health (04/10/25)
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  • Claims Manager

    CHS (Clearwater, FL)
    …for Claims Department strategy, planning, staffing projection, budgeting and quality assurance and improvement. * Responsibility for final hiring decisions ... **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
    CHS (04/14/25)
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  • Director, Application Support and Quality

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    About The Role The Director of Application Support and Quality Assurance will oversee initiatives that align with the strategic goals of the ASG department. This ... to drive business growth, with a strong emphasis on quality control and improvements to enhance claims ... core platform strategic roadmap. + Establishes processes to audit configuration before deployment to production to streamline timeline… more
    Brighton Health Plan Solutions, LLC (04/19/25)
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  • Quality Assurance Specialist (Title…

    Army National Guard Units (Decatur, IL)
    …TITLE 32 EXCEPTED SERVICE POSITION. This National Guard position is for a QUALITY ASSURANCE SPECIALIST (TITLE 32), Position Description Number D1065000 and is ... part of the IL AASF 1, National Guard. Responsibilities As a QUALITY ASSURANCE SPECIALIST (TITLE 32), GS-1910-9, you will establish, develop, and implement the… more
    Army National Guard Units (03/07/25)
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  • Fraud & Claims Management Quality

    Wells Fargo (Chandler, AZ)
    …to ensure deliverables are met timely and accurately. + Lead the FCM Claims Assurance Quality Control organization including developing and executing ... Quality Control Director to join the Fraud & Claims Management (FCM) Quality Control team. **Key...they are belonging and contributing. + Partner with internal audit , IT&V, regulators, and other key stakeholders to help… more
    Wells Fargo (04/12/25)
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  • Senior Claims Specialist

    Axis (Chicago, IL)
    …& Quality Assurance - Comply with best practices measured by monthly Quality Assurance and Management Initiated Audit scores as well as the ... part in the selection process. AXIS is seeking a Senior Claims Specialist to join our North America Claims team reporting to the Manager of Casualty Claims .… more
    Axis (03/26/25)
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  • Senior Claims Specialist

    Axis (New York, NY)
    …& Quality Assurance - Comply with best practices measured by monthly Quality Assurance and Management Initiated Audit scores as well as the ... taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims... Claims Specialist** AXIS is seeking a Senior Claims Specialist to join our North America Claims more
    Axis (03/26/25)
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  • Quality Assurance

    Continental (Wahpeton, ND)
    …Europe and North and South America + The Wahpeton, ND location is seeking a Quality Assurance Specialist/Engineer to join our team. **HOW YOU WILL MAKE AN ... suppliers and customers as necessary. This position is ideal for someone passionate about quality assurance and eager to grow their career in a dynamic… more
    Continental (05/03/25)
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  • Medical Quality Assurance /Risk…

    Robert Half Accountemps (Los Angeles, CA)
    Description A National Healthcare Organization is seeking a knowledgeable and detail-oriented Quality Assurance /Risk Analyst to join its Los Angeles Team. This ... the effectiveness of insurance and risk management programs. + Claims Management: Collaborate with the Risk Management team to...Medicare - Medicaid, Medical Insurance, Risk Management, QA - Quality Assurance Robert Half is the world's… more
    Robert Half Accountemps (04/26/25)
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  • Regulatory Claims Analyst - FHA Part B…

    TEKsystems (Detroit, MI)
    …Minimum 4+ years of experience in the mortgage industry conducting Default Servicing, claims filing, quality assurance or compliance filing - Must ... to look up: CMAX, Venderscape, Docuware, Assurant, Safegaurd, Meta, GFX Wires, USDA claims site, Moveit, Synergy, Quality Claims , and iDesk application,… more
    TEKsystems (05/01/25)
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  • Department Manager - Quality

    United States Steel (Ecorse, MI)
    …Description: U. S. Steel Corporation has an opening for a Department Manager - Quality Assurance at its Great Lakes facility located in Ecorse, MI. ... years of experience in steelmaking operations which demonstrates technical expertise in Quality Assurance activities + Excellent interpersonal skills with the… more
    United States Steel (03/19/25)
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  • Healthcare Process Risk Senior Associate (Internal…

    Grant Thornton (San Francisco, CA)
    …risk management programs, and/or entity-level and business process controls for Internal Audit , or other risk management, compliance, and assurance activities + ... Grant Thornton LLP, a licensed, certified public accounting (CPA) firm that provides audit and assurance services ― and Grant Thornton Advisors LLC (not… more
    Grant Thornton (04/05/25)
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  • Healthcare Process Risk Manager (Internal…

    Grant Thornton (Atlanta, GA)
    …Grant Thornton LLP, a licensed, certified public accounting (CPA) firm that provides audit and assurance services ― and Grant Thornton Advisors LLC (not ... and the overall effectiveness and efficiency of processes. + Oversee internal audit outsourcing and co-sourcing engagements for clients. + Manage the risk… more
    Grant Thornton (04/05/25)
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  • Recovery & Resolution Analyst

    Prime Therapeutics (Columbus, OH)
    …to include:##1 year of work experience in claims processing in an operations, audit or quality assurance environment##1 year of work experience in ... for recoupment of audits and investigations performed by the Pharmacy Audit Operations and Special Investigations Unit (SIU) teams. **Responsibilities** + Perform… more
    Prime Therapeutics (04/18/25)
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  • Executive Director of R&D Global Quality

    Otsuka America Pharmaceutical Inc. (Columbus, OH)
    …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain clinical… more
    Otsuka America Pharmaceutical Inc. (04/30/25)
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  • DRG Coding Auditor

    Elevance Health (Tampa, FL)
    …at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance , or recovery auditing. + Requires at least one ... responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of...Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge… more
    Elevance Health (04/29/25)
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