Claims Quality Audit Representative Jobs (NOW HIRING)

In this role, the Claims Quality Assurance Specialist will conduct pre- and post-payment claims audits to ensure claim accuracy, regulatory compliance, and adherence to company policies. The Claims ...

Integra Partners in Troy, Michigan is seeking a Claims Quality Assurance Analyst. This role ... The Analyst will support quality outcomes by identifying audit findings and collaborating with ...

... Quality, Appeals and Recovery staff * Monitor and review claims audit and transaction reports ... Representatives have a thorough understanding of Company claims adjudication policies and ...

Design and implement QA audit methodology, scoring models, and sampling strategies. * Evaluate ... Claims Performance Intelligence & Analytics * Partner with leadership to define and align claims ...

The Claims Quality Business Analyst is responsible for analyzing claims operations, payment ... Experience supporting CMS audits and regulatory compliance activities. * Knowledge of encounter ...

In this role, the Claims Quality Assurance Specialist will conduct pre- and post-payment claims audits to ensure claim accuracy, regulatory compliance, and adherence to company policies. The Claims ...

... Quality, Appeals and Recovery staff * Monitor and review claims audit and transaction reports ... Representatives have a thorough understanding of Company claims adjudication policies and ...

... Quality, Appeals and Recovery staff * Monitor and review claims audit and transaction reports ... Representatives have a thorough understanding of Company claims adjudication policies and ...

The Claims Quality Assurance Analyst reviews claim audit results and claim transactions, as well as evaluates both verbal and written contacts, to ensure accuracy, completeness, proper documentation ...

The Claims Quality Business Analyst is responsible for analyzing claims operations, payment ... Experience supporting CMS audits and regulatory compliance activities. * Knowledge of encounter ...

The Claims Quality Assurance Analyst reviews claim audit results and claim transactions, as well as evaluates both verbal and written contacts, to ensure accuracy, completeness, proper documentation ...

The Claims Quality Assurance Analyst reviews claim audit results and claim transactions, as well as evaluates both verbal and written contacts, to ensure accuracy, completeness, proper documentation ...

The Team Leader Claims Quality Assurance Auditor-Trainer leads training and quality assurance ... The position independently performs complex, targeted, and high-risk audits; identifies trends and ...

The position independently performs complex, targeted, and high-risk audits; identifies trends and ... The Team Leader Claims Quality Assurance Auditor and Trainer plays a key role in maintaining ...

Own the end-to-end audit and validation of complex claims system configurations, confirming ... Report on quality and risk: Prepare and maintain audit results, quality metrics, and ad hoc reports ...

... claims and call representatives are applying approved procedures consistently, using accurate ... Quality and Compliance Oversight · Review claim samples, adjustment activity, audit results, call ...

Under technical direction, conducts on-site Claim audits of Auto Physical Damage Only (APD) and ... Conduct Quality Assurance post-decision audits of insurance claims, in accordance with established ...

... claims and call representatives are applying approved procedures consistently, using accurate ... Quality and Compliance Oversight • Review claim samples, adjustment activity, audit results, call ...

Conduct Quality Assurance post-decision audits of insurance claims, in accordance with established strategies and objectives, focusing on: Decision accuracy, consistency, and timeliness, Risk ...

Under technical direction, conducts on-site Claim audits of Auto Physical Damage Only (APD) and ... Conduct Quality Assurance post-decision audits of insurance claims, in accordance with established ...