- 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 ... efficiency. How you will create an impact + Complete quality reviews on all files within program guidelines while...skill enhancement. What you'll need to succeed + Proven claims experience handling and auditing Workers Compensation… more
- Dignity Health (Bakersfield, CA)
- **Job Summary and Responsibilities** The Claims Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a ... managed care service organization. This role involves auditing claims , identifying errors, and implementing corrective...improve overall claims accuracy and efficiency. The Claims Quality Specialist will work… more
- Axis (Alpharetta, GA)
- …upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist ** AXIS is seeking a Senior Claims Specialist ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims management...plus. **What will you do in this role?** + Auditing of Third-Party Administrators to ensure reserve adequacy. +… more
- MetLife (Warwick, RI)
- …support of the Pre-QA Program, claim file reviews and call monitoring auditing claim file reviews to identify improvement opportunities, skillset gaps, trends for ... quality , service and/or compliance * Accountable for Reviews and...member(s) within authority limit including Financial accuracy of coding Claims System including accurate claim Benefit Amount/Salary and appropriately… more
- Access Dubuque (Dubuque, IA)
- Quality Assurance Specialist **Green Industrial Supply, Inc.** 1 Positions ID: 83322 Posted On 10/17/2025 Refreshed On 11/17/2025 **Job Overview** **Summary** ... **┬a** The Quality Assurance ...the Production Part Approval Process (PPAP), warranty and freight claims , handling non-conforming products, maintaining ISO compliance, performing calibrations,… more
- University of Southern California (Alhambra, CA)
- … Specialist " analyze, investigate, mitigate, and resolve all coding-related ' claims denials' and ' claims rejections,' specific to ICD-10-CM, ICD-10-PCS, ... the denial management process for coding-related denials, triage denied claims to distinguish coding-related denials versus clinical-related denials, evaluating … more
- Metropolitan Council (St. Paul, MN)
- …to fill future vacancies. What you would do in this job Accounts Payable Specialist + Audit bills, claims and related documents by recalculating and reviewing ... Accounts Payable Specialist or Senior Account Payable Specialist ...will be responsible to audit and process bills and claims ; post transactions; balance and reconcile accounts in order… more
- BrightSpring Health Services (Englewood, CO)
- …Inc. is a leading provider in home Infusion therapy. We are looking for a Billing Specialist to join our Revenue Cycle Management team as we grow to be one of the ... top home infusion providers in the country. The Billing Specialist will report to the Billing Manager and work...an industry shift from hospital delivery settings to lower-cost, high- quality alternative providers such as Amerita. As a core… more
- Southern Glazer's Wine and Spirits (Lakeland, FL)
- …(Depots). This position will complement these teams with technical, data management, compliance, auditing , and tactical support. The EHS Specialist will serve as ... that truly cares about its people. **Overview** The EHS Specialist reports to the Director of EHS and supports...national programs, and corrective actions associated with our compliance auditing program. This role supports SGWS in achieving our… more
- New York State Civil Service (New York, NY)
- …Services Specialist 4 (Risk), SG-27 Occupational Category Financial, Accounting, Auditing Salary Grade 27 Bargaining Unit PS&T - Professional, Scientific, and ... of Financial Services is seeking candidates for the position of Financial Services Specialist 4 (Risk) within the Property Bureau. Duties include, but are not… more
- Zurich NA (Salem, OR)
- …workstreams + Experience in a transactional, operational or customer service environment + Quality auditing experience + Knowledge of the insurance industry and ... Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am...continuous process and system enhancements to improve operational efficiencies, quality and/or timeliness. At Zurich North America Claims… more
- CareFirst (Baltimore, MD)
- …to support effective partnership with provider entities and guidance on the appropriate quality measure capture and proper use of CPT, HCPCS, and ICD 10 codes ... in claims submissions. Utilizes coding expertise, combined with medical policy,...expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity.… more
- Cedars-Sinai (CA)
- **Job Description** The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring program ... rules and regulations including but not limited to AB1455 and Medicare Claims Processing Guidelines. This position is responsible for maintaining routine auditing… more
- MyFlorida (Alachua, FL)
- …action, equal employment opportunity, regulatory work as a paraprofessional or higher, claims adjusting, auditing , financial examining, land appraisal work, land ... INVESTIGATION SPECIALIST II - 64000157 1 1 Date: Nov...Estimator Tool (https://compcalculator.myflorida.com/) Department of Health Division of Medical Quality Assurance Bureau of Enforcement Investigative Services Unit -… more
- C&W Services (New York, NY)
- **Job Title** HSSE Regional Specialist **Job Description Summary** POSITION SUMMARY The Environmental Health & Safety (EH&S) Manager is responsible for providing ... report and manage the corrective actions * Support Workers Compensation (WC) claims tracking, investigation, and management process * Liaise with WC Program Manager… more
- Independent Health (Buffalo, NY)
- …fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical decisions on ... proficiency demonstrated by long-standing, consistent results, advanced coding knowledge and auditing skills evidenced by their ability to train others, to identify… more
- Henry Ford Health System (Jackson, MI)
- …of their quality rewards program. o Maintains accurate record of specialist referral information, provider panel status by product line, and Network's criteria ... obligations. The role performs further credentialing functions including resolving claims issues, assisting with onboarding new practices, and conducting audits… more
- Robert Half Accountemps (Nashua, NH)
- Description Nashua, NH - ON-SITE - Patient Access Specialist - 3rd Shift Position Hours 11:00am-7:00pm - Multiple Openings We are looking for a dedicated Patient ... Access Specialist to join our team in Nashua, New Hampshire....input benefit data to support billing processes and enhance claims accuracy. * Utilize software tools to identify potential… more
- Wabtec Corporation (Chicago, IL)
- …we want someone who is ready to move with us. **Locomotive Materials Specialist ** Don't have experience with locomotives? That's ok! We provide in-depth training to ... give our materials specialist the knowledge and expertise needed to be successful....required, including having a flexible work schedule to perform auditing and training on various shifts. **What will your… more
- Walden Security (Atlanta, GA)
- … Quality Assurance initiatives, including record keeping, training and auditing . + Answers DOL unemployment inquiries and completes verification of employment ... in the filing of FMLA requests and Workers' Compensation claims . + Assists the Human Resources Manager with DOL...This job has no supervisory responsibilities. The Human Resources Specialist reports to the Human Resources Manager and is… more