Manual QA Claims Tester
Getzville, NY · On-site
Manual QA Claims Testers Location : Getzville,NY Duration : 6 + Months * Facets- hands-on experience in configuration and administration of Trizetto claims solution. * Healthcare- 5-10 years+ in ...
Manual QA Claims Tester
Getzville, NY · On-site
Manual QA Claims Testers Location : Getzville,NY Duration : 6 + Months * Facets- hands-on experience in configuration and administration of Trizetto claims solution. * Healthcare- 5-10 years+ in ...
Manual QA Claims Tester
Albany, NY · On-site
Manual QA Claims Tester Location: Albany, NY Duration:12 months Interview: Phone and Skype 1) Facets- hands-on experience in configuration and administration of Trizetto claims solution. 2) Health ...
Manual QA Claims Tester
Albany, NY · On-site
Manual QA Claims Tester Location: Albany, NY Duration:12 months Interview: Phone and Skype 1) Facets- hands-on experience in configuration and administration of Trizetto claims solution. 2) Health ...
The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary ...
Quick apply
The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary ...
Quality Assurance & Claims Coordinator Middlefield, OH | Hourly / Non-Exempt | Quality Department Reports To: Senior Quality Manager, Ohio Campus Position Summary The Quality Assurance & Claims ...
Quality Assurance & Claims Coordinator Middlefield, OH | Hourly / Non-Exempt | Quality Department Reports To: Senior Quality Manager, Ohio Campus Position Summary The Quality Assurance & Claims ...
Quality Assurance & Claims Coordinator Middlefield, OH | Hourly / Non-Exempt | Quality Department Reports To: Senior Quality Manager, Ohio Campus Position Summary The Quality Assurance & Claims ...
Quality Assurance & Claims Coordinator Middlefield, OH | Hourly / Non-Exempt | Quality Department Reports To: Senior Quality Manager, Ohio Campus Position Summary The Quality Assurance & Claims ...
Claims Quality Assurance
San Diego, CA · On-site
$70K - $116K/yr
The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary ...
Claims Quality Assurance
San Diego, CA · On-site
$70K - $116K/yr
The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary ...
The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary ...
The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary ...
Quality Assurance Reviewer II - Hybrid / Primarily Remote
Macedonia, OH · On-site
$58K - $68K/yr
Prior QA, claims management, or medical-legal review experience a plus; outstanding new graduates considered. Benefits * 401(k) with company match * Health, Dental, Vision, and Life Insurance
Quick apply
Quality Assurance Reviewer II - Hybrid / Primarily Remote
Macedonia, OH · On-site
$58K - $68K/yr
Prior QA, claims management, or medical-legal review experience a plus; outstanding new graduates considered. Benefits * 401(k) with company match * Health, Dental, Vision, and Life Insurance
Disability Claims QA
$22 - $30/hr
As a Disability Claims QA - Long Term Disability Specialist, you will leverage your expertise in long-term disability claims to review and ensure to accuracy and completeness of reports accompanying ...
Disability Claims QA
$22 - $30/hr
As a Disability Claims QA - Long Term Disability Specialist, you will leverage your expertise in long-term disability claims to review and ensure to accuracy and completeness of reports accompanying ...
The Contractor shall provide expertise in quality assurance, claims processing, medical coding, and audit activities for the WTC Health Program. Responsibilities include supporting quality assurance ...
The Contractor shall provide expertise in quality assurance, claims processing, medical coding, and audit activities for the WTC Health Program. Responsibilities include supporting quality assurance ...
The Contractor shall provide expertise in quality assurance, claims processing, medical coding, and audit activities for the WTC Health Program. Responsibilities include supporting quality assurance ...
The Contractor shall provide expertise in quality assurance, claims processing, medical coding, and audit activities for the WTC Health Program. Responsibilities include supporting quality assurance ...
The Contractor shall provide expertise in quality assurance, claims processing, medical coding, and audit activities for the WTC Health Program. Responsibilities include supporting quality assurance ...
The Contractor shall provide expertise in quality assurance, claims processing, medical coding, and audit activities for the WTC Health Program. Responsibilities include supporting quality assurance ...
Quality Assurance Specialist (Storm Claims) **role will be filled at appropriate level based on experience** Do you pay great attention to detail, and have strong organizational and time management ...
Quality Assurance Specialist (Storm Claims) **role will be filled at appropriate level based on experience** Do you pay great attention to detail, and have strong organizational and time management ...
Allcat Claims Service, LLC To know more, visit us at ABOUT ALLCAT CLAIMS SERVICE Established over ... This position is part of the Quality Assurance Department. The primary function of this role is to ...
Allcat Claims Service, LLC To know more, visit us at ABOUT ALLCAT CLAIMS SERVICE Established over ... This position is part of the Quality Assurance Department. The primary function of this role is to ...
Allcat Claims Service, LLC To know more, visit us at ABOUT ALLCAT CLAIMS SERVICE Established over ... This position is part of the Quality Assurance Department. The primary function of this role is to ...
Allcat Claims Service, LLC To know more, visit us at ABOUT ALLCAT CLAIMS SERVICE Established over ... This position is part of the Quality Assurance Department. The primary function of this role is to ...
Quality Assurance Associate
Fort Lauderdale, FL · On-site
$20 - $21/hr
The Quality Assurance Associate is responsible for planning, developing, implementing, and ... Completes liability, auto and property claims reports * Conducts initial liability claims ...
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Quality Assurance Associate
Fort Lauderdale, FL · On-site
$20 - $21/hr
The Quality Assurance Associate is responsible for planning, developing, implementing, and ... Completes liability, auto and property claims reports * Conducts initial liability claims ...
Quality Assurance Associate
Fort Lauderdale, FL · On-site
$20 - $21/hr
The Quality Assurance Associate is responsible for planning, developing, implementing, and ... Completes liability, auto and property claims reports * Conducts initial liability claims ...
Quick apply
Quality Assurance Associate
Fort Lauderdale, FL · On-site
$20 - $21/hr
The Quality Assurance Associate is responsible for planning, developing, implementing, and ... Completes liability, auto and property claims reports * Conducts initial liability claims ...
Oversees, in conjunction with the Managed Care Management Team, to ensure QA programs are aligned with claims operations and other areas that have direct impact with claims to prevent non-compliance.
Oversees, in conjunction with the Managed Care Management Team, to ensure QA programs are aligned with claims operations and other areas that have direct impact with claims to prevent non-compliance.
Quality Assurance Specialist - Claims
Omaha, NE · On-site
$56K - $75K/yr
Demonstrates that the focus of quality assurance reviews are proper and handles investigations, evaluations, negotiations and the settlement of claims with moderate to serious severity/complexity.
Quality Assurance Specialist - Claims
Omaha, NE · On-site
$56K - $75K/yr
Demonstrates that the focus of quality assurance reviews are proper and handles investigations, evaluations, negotiations and the settlement of claims with moderate to serious severity/complexity.
Quality Assurance Handler
Dallas, TX · On-site
$70K - $100K/yr
Ready to grow your claims career faster than the traditional industry allows? We're looking for a Quality Assurance Handler to join ClaimSorted. This role is ideal for: * a Quality Assurance Handler ...
Quality Assurance Handler
Dallas, TX · On-site
$70K - $100K/yr
Ready to grow your claims career faster than the traditional industry allows? We're looking for a Quality Assurance Handler to join ClaimSorted. This role is ideal for: * a Quality Assurance Handler ...
Qa Claims information
See salary details
$15.38 - $18.16
8% of jobs
$18.16 - $20.94
11% of jobs
$22.09 is the 25th percentile. Wages below this are outliers.
$20.94 - $23.71
13% of jobs
$23.71 - $26.49
17% of jobs
The median wage is $26.83 / hr.
$26.49 - $29.26
8% of jobs
$29.26 - $32.04
9% of jobs
$34.50 is the 75th percentile. Wages above this are outliers.
$32.04 - $34.81
9% of jobs
$34.81 - $37.59
9% of jobs
$37.59 - $40.36
3% of jobs
$40.36 - $43.14
5% of jobs
$43.14 - $45.91
6% of jobs
$15
$29
$45
How much do qa claims jobs pay per hour?
As of Jul 7, 2026, the average hourly pay for qa claims in the United States is $29.40, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $35.10 per hour, depending on experience, location, and employer.
What is a QA Claims job?
A QA Claims job involves reviewing and analyzing insurance claims to ensure accuracy, compliance, and adherence to company policies and industry regulations. Professionals in this role identify errors, inconsistencies, or potential fraud while providing feedback for process improvements. They work closely with claims adjusters and management to enhance efficiency and maintain quality standards. Strong attention to detail, analytical skills, and knowledge of insurance guidelines are essential for success in this role.
What are the typical daily tasks and challenges faced in a QA Claims position?
A QA Claims role involves reviewing claims files for accuracy, completeness, and compliance with company policies and regulations, often requiring careful analysis and documentation. You may be tasked with identifying trends, proposing process improvements, and providing feedback or training to claims adjusters to enhance quality standards. One common challenge is balancing the high volume of claims with the need for thorough quality checks, especially during peak periods. These professionals often collaborate closely with claims teams, auditors, and compliance staff to resolve complex cases and streamline workflows, making attention to detail and strong communication essential for success.
What are the key skills and qualifications needed to thrive in the Qa Claims position, and why are they important?
To thrive as a QA Claims professional, you need a strong understanding of insurance claims processes, quality assurance methodologies, and attention to detail, often supported by industry certifications such as CPCU or AIC. Familiarity with claims management systems, data analysis tools, and workflow tracking software is typically required. Excellent analytical thinking, effective communication, and problem-solving skills help you excel in identifying discrepancies and collaborating with adjusters or other departments. These abilities are vital for ensuring claim accuracy, regulatory compliance, and continuous process improvement within an insurance organization.
More about Qa Claims jobs
What cities are hiring for Qa Claims jobs? Cities with the most Qa Claims job openings:
What states have the most Qa Claims jobs? States with the most job openings for Qa Claims jobs include:
What job categories do people searching Qa Claims jobs look for? The top searched job categories for Qa Claims jobs are:
Full-time
Re-posted 10 days ago
Job description
Role : Manual QA Claims Testers
Location : Getzville,NY
Duration : 6 + Months
Job Description:
Location : Getzville,NY
Duration : 6 + Months
Job Description:
- Facets- hands-on experience in configuration and administration of Trizetto claims solution.
- Healthcare- 5-10 years+ in healthcare claims experience, ideally facets claims systems
- Requirements Management- 5+ years' experience in working with business or IT executives/sponsors to gather requirements, understand business needs and provide solutions.
- Prepared Test cases and Test scripts from the requirements and Functional, Technical specifications.
- Validated member eligibility and eligibility inquiry in the facets application to the legacy application in order to confirm the migration successful or not.
- Experience in Medical, Pharmacy Plan changes from one plan to other plan with in Group, subgroup, class combinations.
- Experience with COB (coordination of benefits) application with in facets, testing of claims status for selected subscribers.
- Writing test cases and test scripts in MS Excel Manually and uploading in Quality center
- Well experienced in benefit coding of different products for various plans of BCBS such as Blue preferred, Blue exchange etc..
- Calculating co-pay, coinsurance, adding single tier, multi tier for different products with in a plan.
- Comparing plan and product details in medical module, and reviewing the benefit summary and feeding them into pivot tables with appropriate co-pay and coinsurance and valid comments for various codes of vision, maternity etc..
- Test data entry into FACETS4.7 application in the test environment for creating groups, subscribers and family members.
- Experience in creating new groups, subgroups, subscribers as and when needed which is later used as a test data for testing purpose.
- Experience in System testing and UAT testing of the facets core application and custom modules as needed.
- Claims validation in Facets application which includes claims pending status, member status, etc..
- Creating test cases, test scripts for various modules, and uploading them into quality center.
About Avani Technology Solutions
Sourced by ZipRecruiter
Industry
It services
Company size
201 - 500 Employees
Headquarters location
Rochester, NY, US
Year founded
2008