- USAA (Phoenix, AZ)
- …makes us special and impactful. **The Opportunity** As a dedicated ** Quality Assurance Advisor Senior** for the Property Claims Team, you will be responsible ... industry, Property Claims . + 2 years of quality assurance /control, or quality improvement...+ 1+ years in demonstrated direct experience in an audit , risk and/or compliance roles. + Detail oriented with… more
- AIG (Atlanta, GA)
- Claims , Quality Assurance Specialist - Worker's Compensation Join us as a Claims QA Specialist to make more of your specialist expertise and experience. ... skills with ability to create consistently factual, correct, high quality audit reports and supporting documentation. +...+ Ability to address queries, disputes, challenges through the claims audit cycle while maintaining the philosophies… more
- Grant Thornton (New York, NY)
- As a Process Risk & Claims Audit Manager, you will get the opportunity to grow and contribute to our clients' business needs by helping them understand their ... achieve more, confidently. Your day-to-day may include: + Leverage claims operations experience and claim audit experience...a licensed, certified public accounting (CPA) firm that provides audit and assurance services ― and Grant… more
- AIG (Charlotte, NC)
- …SCUP, Claims , Japan Transformation, Data Engineering, and myAIG, ensuring quality assurance at every phase. + Drive GenAI-based transformation initiatives ... (QE&A) organization. This pivotal role combines deep domain expertise in Quality Assurance , cutting-edge automation practices, and Generative AI (GenAI)… more
- 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
- The Raymond Corporation (Muscatine, IA)
- …9001, and internal audit expectations. * Support production teams in quality assurance , problem resolution, and process capability improvements. * Manage ... Join our Raymond Team as a Quality Assurance Manager! The Role: We’re...indicators (KPIs) including scrap, rework, customer complaints, and warranty claims . Use data to drive improvement. * Work with… more
- Commonwealth Care Alliance (Boston, MA)
- …states will not be considered at this time._** **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance , the Claims Sr. ... Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance ,...claims systems (eg, Salesforce, Facets) in compliance with audit standards and MassHealth requirements. + Maintain awareness of… more
- Molina Healthcare (AZ)
- …leading readiness, cutover planning, and post-go live stabilization. + Hands-on governance, quality assurance , risk management, and escalation handling in a ... hypothesis, and measurable success criteria (eg, first-pass resolution, auto-adjudication rate, claims cycle time, audit findings, cost-to-serve). + Process… more
- Axis (Alpharetta, GA)
- …& 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
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …for enhancing operational efficiency, in alignment with the Company's commitment to quality assurance and continuous improvement methodology, including the use ... colors to blue. As a valued member of the Audit and Risk Management (ARM) team, the Senior Internal...is a key contributor to the organization, providing critical assurance that risks are being managed effectively. The ideal… more
- PennyMac (Fort Worth, TX)
- …+ Develop required process infrastructure, policies, procedures, and operational routines + Audit functions/ quality assurance of key processes to ensure ... of homeownership through the complete mortgage journey. A Typical Day The Claims Supervisor is responsible for providing structure and oversight to the post-sale… more
- City of New York (New York, NY)
- …and Department of Homeless Services (DHS). DSS-AO maintains the operation of the Office of Audit and Quality Assurance (OAQA), Office of Compliance & Support ... to function as a(n) Executive Director, Financial Review & Claims Processing who will: - Manage, plan and develop...of DFRP, ICP and SNAP-CR. - Establish criteria and high- quality standards, policies and procedures that comply with current… more
- NJM Insurance (Trenton, NJ)
- Reporting to the Workers' Compensation (WC) Training and Quality Assurance Management Supervisor, the WC Quality Assurance /Compliance Analyst is ... to present to management. + Collaborate with the BPU, claims management, law and regulation, and internal audit...develop resources and training material to support regulatory and Quality Assurance compliance + Attend internal and… more
- CGI Technologies and Solutions, Inc. (Indianapolis, IN)
- ** Quality Analyst** **Category:** Testing/ Quality Assurance **Main location:** United States, Indiana, Indianapolis **Position ID:** J0825-0830 **Employment ... such as Great Expectations, Soda, or custom Python/SQL test harnesses to automate quality assurance processes. * Validate data migration efforts from legacy… 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 ... claims processing platform. . Manages case volumes and review/ audit schedules, prioritizing case load as assigned by Management....Level I Qualifications) . Five (5) years' experience in claims auditing, quality assurance , or… more
- Boar's Head Brand/Frank Brunckhorst Co., LLC (Sarasota, FL)
- …+ Provide advanced super user support to functional groups (R&D, Procurement, Engineering, Quality Assurance , and Manufacturing) on QMS related issues. + Provide ... Audit Team with performing Food Safety & Product Quality audits at different venues to include but not...COAs, Allergen forms, Weight & Tare, any other product claims , etc.), as applicable. + Perform Food Safety &… more
- Elevance Health (Hanover, MD)
- …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
- Sedgwick (Albuquerque, NM)
- …from an accredited college or university preferred. **Experience** + Minimum of 2 years in claims , auditing, or quality assurance . + At least 1 year of ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Control Representative - Heavy Equipment/Specialty **PRIMARY PURPOSE:** The Quality… more
- Kohler Co. (Huntsville, AL)
- …of those goals for plant Quality team. + Effectively Build and Lead the quality assurance and control team and functions, including quality engineers as ... meetings in accordance with ISO 9000 standards. + Develop, implement, enforce, and audit work procedures which ensure quality products produced at an economical… more
- AUI Partners (TX)
- … control measures, and drive continuous improvement initiatives. Develop & Implement AUI's Quality Control/ Quality Assurance Program: Develop and implement a ... assist in the management of mitigating and resolving potential claims . Assist in reviewing Plans do quality ...review of drawings when requested. Monitor and Enforce AUI's Quality Control/ Quality Assurance Program: Coordinate… more