- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Claims Quality Review Auditor is HYBRID position accountable for auditing various claims to ensure quality and accuracy to ... and procedures and regulatory guidelines. Makes recommendations to improve quality , workflow processes, policies and procedures. **ESSENTIAL FUNCTIONS OF THE… more
- The Cigna Group (Bloomfield, CT)
- …Growth and Change Lives? EviCore, a division of the Cigna Group is hiring a Claims Systems Configuration Quality Review Senior Analyst. For this highly ... were input correctly per the specifications of the provider. The Claims Configuration Quality Review Senior Analyst will have in depth knowledge… more
- TEKsystems (Rochester Hills, MI)
- …claims to payors for reprocessing. * Work AR aging reports for payors. * Review claims forms to primary, secondary, and tertiary insurance payors as needed. ... Rochester Hills MI Pay Rate Range: 20/HR. We are paid WEEKLY Benefits: Yes "Pull claims , review them to see where they are at in the process, have they been… more
- LA Care Health Plan (Los Angeles, CA)
- … Quality Auditor researches on complex claims problems. Duties Performs high quality review of payable and post payment claims in a rapidly changing ... Claims Quality Auditor II Job Category:...work environment. Perform random review of claims audited by the Quality Control Examiners...review of claims audited by the Quality Control Examiners to ensure they are meeting a… more
- Sedgwick (San Diego, CA)
- …+ Compiles reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, ... service contract requirements, and quality standards. + Acts as second level of appeal...authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated … more
- Sedgwick (Sacramento, CA)
- …+ Compiles reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, ... service contract requirements, and quality standards. + Acts as second level of appeal...authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated … more
- Sedgwick (Syracuse, NY)
- …+ Compiles reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, ... service contract requirements, and quality standards. + Acts as second level of appeal...authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated … more
- Sedgwick (Indianapolis, IN)
- …* Compiles reviews and analyzes management reports and takes appropriate action. * Performs quality review on claims in compliance with audit requirements, ... service contract requirements, and quality standards. * Acts as second level of appeal...authority of the individual examiner. * Monitors third party claims ; maintains periodical review of litigated … more
- Sedgwick (West Hills, CA)
- …+ Compiles reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, ... service contract requirements, and quality standards. + Acts as second level of appeal...authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated … more
- Sedgwick (Long Beach, CA)
- …+ Compiles, reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, ... service contract requirements and quality standards. + Reviews reserve...the authority of individual PL Specialists. + Maintains periodic review of claims that are litigated, sensitive,… more