Medical Claims Auditor

We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of Commercial, Medicare Advantage, and Medi-Cal claims will make you a great candidate, along with...

Job DescriptionJob DescriptionMedical Billing Auditor | Medical Insurance Denial RepresentativeOKC, OK M-F 8a-5p$17-$20/HRExperience reading EOBsWork denials and understand denial codes and modifiers2+ years current experience requiredThe Billing Office Representative is responsible for processing medical claims. Duties include for verifying all patient...

Job DescriptionJob DescriptionMedical Billing Auditor | Medical Insurance Denial RepresentativeOKC, OK M-F 8a-5p$17-$20/HRExperience reading EOBsWork denials and understand denial codes and modifiers2+ years current experience requiredThe Billing Office Representative is responsible for processing medical claims. Duties include for verifying all patient...

Job Description What will I be doing in this role? The Senior Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with, educates, and trains providers and staff on results, identifies issues and/or...

Job Description What will I be doing in this role? The Senior Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with, educates, and trains providers and staff on results, identifies issues and/or risks...

Job DescriptionJob DescriptionWe are hiring for Claims Analysts to join the team! The Claims Analyst role analyzes international insurance claims to determine the type of services rendered. When processing Classic claims, this position determines the extent of insurance carrier's liability and settles claims in accordance with policy provision. Claims...

Job DescriptionJob DescriptionWe are hiring for Claims Analysts to join the team! The Claims Analyst role analyzes international insurance claims to determine the type of services rendered. When processing Classic claims, this position determines the extent of insurance carrier's liability and settles claims in accordance with policy provision. Claims...

Job Description What will I be doing in this role? The Senior Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with, educates, and trains providers and staff on results, identifies issues and/or risks...

Job Description Job Description We are hiring for Claims Supervisors to join the team! The Supervisor Claims is responsible for coaching and developing employees to ensure that department quality and service level requirements are met. This will include monitoring staff quality and productivity results and assisting management with overseeing the daily...

Job DescriptionWhat will I be doing in this role?The Senior Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with, educates, and trains providers and staff on results, identifies issues and/or risks...

Your Role The Delegation Oversight Utilization Management team is responsible for the organization, tracking and data entry of IPA Utilization Management audits, issues, complaints and monitoring. Identifies root cause of the problem and maintains monthly reporting that track and compare patters of delegated entities. The Delegation Operations Nurse...

Description: Position: Contract Coordinator This position will assist in the development and management of the contracting process workflow, and other duties as needed by the Contracting Department. The Contract Coordinator will need to be able to multi-task, be articulate and detail-oriented, with excellent reading comprehension and analysis to assist...

Job DescriptionJob DescriptionPosition SummaryAs a Claims Processor, you will play a pivotal role in ensuring the efficiency and accuracy of claims processing within our organization. Your responsibilities will encompass a wide range of tasks, including year-end processing, managing adjustments, coordinating benefits, handling subrogation and high-dollar...

Job DescriptionJob DescriptionSUMMARYResearches insurance claim denials, determines the validity of the claim and when appropriate is responsible for adjusting and resubmitting the claims via multiple methods.ESSENTIAL FUNCTIONS AND RESPONSIBILITIESResearches denial of claims, evaluates and rebills as necessary in an effort to ensure the maximum accurate...

SQA is a leading Quality Assurance and Supply Chain solutions firm. SQA manages Supplier Audit and Supplier Development programs for clients in quality-critical industries, including Pharmaceutical, Medical Device, Automotive, Aerospace, and Electronics manufacturing. Clients leverage SQA's network of Quality Professionals in more than 90 countries as an...

Your Role The Delegation Oversight Utilization Management team is responsible for the organization, tracking and data entry of IPA Utilization Management audits, issues, complaints and monitoring. Identifies root cause of the problem and maintains monthly reporting that track and compare patters of delegated entities. The Delegation Operations Nurse...

A health services organization in New York City is currently seeking an experienced professional to join their staff as their new Director of Claims Quality. In this role, the Director of Claims Quality will be responsible for the creation, delivery and ongoing facilitation of a data and metrics-driven Claims Quality Assurance and Performance oversight...

A health services organization in New York City is currently seeking an experienced professional to join their staff as their new Director of Claims Quality. In this role, the Director of Claims Quality will be responsible for the creation, delivery and ongoing facilitation of a data and metrics-driven Claims Quality Assurance and Performance oversight...

A health services organization in New York City is currently seeking an experienced professional to join their staff as their new Director of Claims Quality. In this role, the Director of Claims Quality will be responsible for the creation, delivery and ongoing facilitation of a data and metrics-driven Claims Quality Assurance and Performance oversight...

A health services organization in New York City is currently seeking an experienced professional to join their staff as their new Director of Claims Quality. In this role, the Director of Claims Quality will be responsible for the creation, delivery and ongoing facilitation of a data and metrics-driven Claims Quality Assurance and Performance oversight...