Quality Auditor
$35K - $48K/yr
HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to ...
50 Healthedge Jobs Hiring Near You
Quality Auditor
$35K - $48K/yr
HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to ...
HealthEdge HRCM, JIRA or Guiding Care experience is a plus Skills/Knowledge/Abilities (SKA) Required: * Strong analytical, planning, problem solving, verbal, and written skills to communicate complex ...
HealthEdge HRCM, JIRA or Guiding Care experience is a plus Skills/Knowledge/Abilities (SKA) Required: * Strong analytical, planning, problem solving, verbal, and written skills to communicate complex ...
HealthEdge HRCM, JIRA or Guiding Care experience is a plus Skills/Knowledge/Abilities (SKA) Required: * Strong analytical, planning, problem solving, verbal, and written skills to communicate complex ...
HealthEdge HRCM, JIRA or Guiding Care experience is a plus Skills/Knowledge/Abilities (SKA) Required: * Strong analytical, planning, problem solving, verbal, and written skills to communicate complex ...
HealthEdge is in a period of rapid growth and consolidation following recent mergers. As we scale, the systems our teams run on need a function that can keep them healthy, scalable and genuinely ...
HealthEdge is in a period of rapid growth and consolidation following recent mergers. As we scale, the systems our teams run on need a function that can keep them healthy, scalable and genuinely ...
Assess current-state operations on legacy platforms (e.g., Facets, QNXT, Javelina, QicLink, homegrown) and define transition pathways to BPaaS delivery models on the HealthEdge ecosystem, including ...
Assess current-state operations on legacy platforms (e.g., Facets, QNXT, Javelina, QicLink, homegrown) and define transition pathways to BPaaS delivery models on the HealthEdge ecosystem, including ...
HealthEdge is seeking a Product Manager with deep expertise in Medicare Fee-for-Service enrollment operations and benefit design to join the HealthRules Payer product team. In this role, you will own ...
HealthEdge is seeking a Product Manager with deep expertise in Medicare Fee-for-Service enrollment operations and benefit design to join the HealthRules Payer product team. In this role, you will own ...
Appeals RN (Temporary)
$50/hr
HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to ...
Appeals RN (Temporary)
$50/hr
HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to ...
Technology Strategy & Solution Architect
$63 - $83/hr
HealthEdge commits to building an environment and culture that supports the diverse representation of our teams. We aspire to have an inclusive workplace. We aspire to be a place where all employees ...
Technology Strategy & Solution Architect
$63 - $83/hr
HealthEdge commits to building an environment and culture that supports the diverse representation of our teams. We aspire to have an inclusive workplace. We aspire to be a place where all employees ...
At HealthEdge, our Centers of Excellence span Human Resources, IT, Legal, and Finance - each providing strategic support to our Product divisions and enabling the enterprise to move forward and ...
At HealthEdge, our Centers of Excellence span Human Resources, IT, Legal, and Finance - each providing strategic support to our Product divisions and enabling the enterprise to move forward and ...
HealthEdge is seeking a Product Manager to own the CMS integration strategy and API connectivity roadmap for HealthRules ® Payer. As federal programs expand their digital infrastructure - from ...
HealthEdge is seeking a Product Manager to own the CMS integration strategy and API connectivity roadmap for HealthRules ® Payer. As federal programs expand their digital infrastructure - from ...
HealthEdge is seeking a Product Manager to own the CMS integration strategy and API connectivity roadmap for HealthRules Payer. As federal programs expand their digital infrastructure - from MACPro ...
HealthEdge is seeking a Product Manager to own the CMS integration strategy and API connectivity roadmap for HealthRules Payer. As federal programs expand their digital infrastructure - from MACPro ...
HealthEdge'smission is to revolutionize healthcare through transactionautomation and enablement of real-time business and clinical engagement among healthcare payers,providers, and patients. Our ...
HealthEdge'smission is to revolutionize healthcare through transactionautomation and enablement of real-time business and clinical engagement among healthcare payers,providers, and patients. Our ...
Technology Strategy & Solution Architect
$64.50 - $85/hr
HealthEdge commits to building an environment and culture that supports the diverse representation of our teams. We aspire to have an inclusive workplace. We aspire to be a place where all employees ...
Technology Strategy & Solution Architect
$64.50 - $85/hr
HealthEdge commits to building an environment and culture that supports the diverse representation of our teams. We aspire to have an inclusive workplace. We aspire to be a place where all employees ...
At HealthEdge, our Centers of Excellence span Human Resources, IT, Legal, and Finance - each providing strategic support to our Product divisions and enabling the enterprise to move forward and ...
At HealthEdge, our Centers of Excellence span Human Resources, IT, Legal, and Finance - each providing strategic support to our Product divisions and enabling the enterprise to move forward and ...
HealthEdge is in a period of rapid growth and consolidation following recent mergers. The Business Technology team exists to make sure the systems that power our business keep up - not just running ...
HealthEdge is in a period of rapid growth and consolidation following recent mergers. The Business Technology team exists to make sure the systems that power our business keep up - not just running ...
HealthEdge is in a period of rapid growth and consolidation following recent mergers. The Business Technology team exists to make sure the systems that power our business keep up - not just running ...
HealthEdge is in a period of rapid growth and consolidation following recent mergers. The Business Technology team exists to make sure the systems that power our business keep up - not just running ...
HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to ...
HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to ...
The Senior Release Coordinator leads the planning, coordination, and execution of complex application releases at HealthEdge. Operating with a high degree of independence, this role serves as a ...
The Senior Release Coordinator leads the planning, coordination, and execution of complex application releases at HealthEdge. Operating with a high degree of independence, this role serves as a ...
HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to ...
HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to ...
The Senior Release Coordinator leads the planning, coordination, and execution of complex application releases at HealthEdge. Operating with a high degree of independence, this role serves as a ...
The Senior Release Coordinator leads the planning, coordination, and execution of complex application releases at HealthEdge. Operating with a high degree of independence, this role serves as a ...
HealthEdge Jobs Information
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Job description
Overview
Overview:
UST HealthProof is looking for a Quality Auditor with health plan claims administration operations experience. This role will report to the Lead Auditor or Quality Audit Manager.
The Opportunity:
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
What You Need:
Geographic Responsibility: Remote, US
Type of Employment: Full-time, permanent
Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:
The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.
HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.
#LI-Remote
**The annual US base salary range for this position is $35,000 to $48,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.
Overview:
UST HealthProof is looking for a Quality Auditor with health plan claims administration operations experience. This role will report to the Lead Auditor or Quality Audit Manager.
The Opportunity:
- Perform audit of transactions processed by health plan administration associates for a specific customer.
- Be responsible for following the customer quality process and tools for audit and rebuttal process.
- Share QA results with individual associates, coordinate with operational Team Leads and managers to provide feedback to individuals, clearly identifying errors and opportunities of improvement.
- Collate, compile and reports both team and individual associates' QA performance to management and individuals.
- Provide inputs to Training team and Team Leads for up-to-date written processing instruction/refresher training needs.
- Participate in semi-annual or annual auditor calibration activities.
- Maintain currency on CMS claims processing rules and guidelines for Medicare Advantage organizations and ACA Exchange and Off Exchange lines of business
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
What You Need:
- High School Diploma or GED required
- 3 years health plan claims auditing operations experience required
- Medicare claims auditing experience preferred
- Proficiency in using MS Suite, specifically Excel, PowerPoint and Outlook
- HealthRules Payor or Guiding Care exp preferred
- Ability to analyze contractual SLAs and KPIs
- Ability to effectively communicate and collaborate with a remote team
Geographic Responsibility: Remote, US
Type of Employment: Full-time, permanent
Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:
- The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
- Work across multiple time zones in a hybrid or remote work environment.
- Long periods of time sitting and/or standing in front of a computer using video technology.
- May require travel dependent on company needs.
The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990. Candidates may be required to go through a pre-employment criminal background check.
HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities.
#LI-Remote
**The annual US base salary range for this position is $35,000 to $48,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.
About HealthEdge
Sourced by ZipRecruiter
Health Edge ® provides modern, disruptive technology that delivers for the first time, a suite of products that enables healthcare payors to leverage new business models, improve outcomes, drastically reduce administrative costs and connect everyone in the healthcare delivery cycle. Our next-generation enterprise product suite, HealthRules ®, is built on modern, patented technology and is delivered to customers via the HealthEdge Cloud or on-site deployment. An award-winning company, HealthEdge empowers payors to capitalize on the innovations, challenges and opportunities that await in the new healthcare economy. For more information, visit .
Industry
Computer and computer peripheral equipment and software wholesalers
Company size
201 - 500 Employees
Headquarters location
Burlington, MA, US
Year founded
2005