Intermediate Quality Auditor II

3 weeks ago


Downey, United States Kaiser Permanente Full time
Job Summary:
Remote from any KP location in CA, OR, CO, WA, GA, MD, VA, HI or D.C. Only. 

** PLEASE NOTE: Salary ranges are geographically based and the posted range reflects the Southern CA region. Applicable salary ranges will apply for other labor markets outside of SCAL.

Quality Claims Auditor: This position exists to ensure the integrity of medical payments for the organization through verification of the accuracy of data-entered information and by auditing service related information and invoice adjudication/payment for compliance with contract terms and Department/Regional policy and procedures.
The auditor must be proficient with the medical systems, claims processing and adjudication. The position requires research, problem resolution and specialized knowledge in the areas of benefits, contracts, Medicare, Medicaid, Coordination of Benefits and Third-Party liability, WebStrat, Multiplan, Beechstreet and other pricers.

Essential Responsibilities:
  • Conducts quality assurance audits for all Lines of Business.
  • Conducts quality assurance audits for claim adjustments, refunds and provider disputes.
  • Performs routine and moderately complex claim audits for payment accuracy in accordance with regulatory standards, and business policies.
  • Participates in some special projects/work.
  • Participates in the appropriate and approved training classes during year (in accordance with goals).
  • Demonstrates awareness of work required at next level and working at that standard.
  • Works on problems of moderate scope where analysis of situations and / or data requires review of variety of factors.
  • Exercises good judgment within defined procedures and practices to determine appropriate action.
  • Builds productive working relationships internally and externally.
  • Presents ideas assertively and directly, providing data to support conclusions.
  • Adapts ideas and ties them to the needs and goals of others to gain their support and commitment.
  • Applies knowledge of internal and external regulatory processing guidelines.


  • Downey, United States Kaiser Permanente Full time

    Job Summary: Remote from any KP location in CA, OR, CO, WA, GA, MD, VA, HI or D.C. Only. ** PLEASE NOTE: Salary ranges are geographically based and the posted range reflects the Southern CA region. Applicable salary ranges will apply for other labor markets outside of SCAL. Quality Claims Auditor: This position exists to ensure the integrity of medical...


  • Downey, United States Kaiser Permanente Full time

    Job Summary: Remote from any KP location in CA, OR, CO, WA, GA, MD, VA, HI or D.C. Only. ** PLEASE NOTE: Salary ranges are geographically based and the posted range reflects the Southern CA region. Applicable salary ranges will apply for other labor markets outside of SCAL. Quality Claims Auditor: This position exists to ensure the integrity of medical...


  • Downey, United States Kaiser Permanente Full time

    **Job Summary**: Remote from any KP location in CA, OR, CO, WA, GA, MD, VA, HI or D.C. Only. Quality Claims Auditor: This position exists to ensure the integrity of medical payments for the organization through verification of the accuracy of data-entered information and by auditing service related information and invoice adjudication/payment for compliance...


  • Downey, United States Kaiser Permanente Full time

    Job Summary: Remote from any KP location in CA, OR, CO, WA, GA, MD, VA, HI or D.C. Only. ** PLEASE NOTE: Salary ranges are geographically based and the posted range reflects the Southern CA region. Applicable salary ranges will apply for other labor markets outside of SCAL. Quality Claims Auditor: This position exists to ensure the integrity of medical...


  • Downey, United States Kaiser Permanente Full time

    Job Summary: Remote from any KP location in CA, OR, CO, WA, GA, MD, VA, HI or D.C. Only. ** PLEASE NOTE: Salary ranges are geographically based and the posted range reflects the Southern CA region. Applicable salary ranges will apply for other labor markets outside of SCAL. Quality Claims Auditor: This position exists to ensure the integrity of medical...

  • Night Auditor

    3 weeks ago


    Downey, United States Hilton Worldwide Full time

    A Night Auditor is responsible for overseeing the auditing, posting and balancing of daily financial transactions to support the hotel's continuing effort to deliver outstanding guest service and financial profitability. Pay rate for this position is $19.00/hr What will I be doing? As Night Auditor, you would be responsible for overseeing the auditing,...

  • Night Auditor

    1 week ago


    Downey, United States Hilton Worldwide Full time

    A Night Auditor is responsible for overseeing the auditing, posting and balancing of daily financial transactions to support the hotel's continuing effort to deliver outstanding guest service and financial profitability. Pay rate for this position is $19.00/hr What will I be doing? As Night Auditor, you would be responsible for overseeing the auditing,...

  • Night Auditor

    3 weeks ago


    Downey, United States Hilton Full time

    Night Auditor A Night Auditor is responsible for overseeing the auditing, posting and balancing of daily financial transactions to support the hotel's continuing effort to deliver outstanding guest service and financial profitability. **What will I be doing?** As Night Auditor, you would be responsible for overseeing the auditing, posting and balancing of...

  • Night Auditor

    3 weeks ago


    Downey, United States Hilton Full time

    A Night Auditor is responsible for overseeing the auditing, posting and balancing of daily financial transactions to support the hotel's continuing effort to deliver outstanding guest service and financial profitability.Pay rate for this position is $19.00/hrWhat will I be doing?As Night Auditor, you would be responsible for overseeing the auditing, posting...

  • Night Auditor

    3 days ago


    Downey, United States Hilton Full time

    A Night Auditor is responsible for overseeing the auditing, posting and balancing of daily financial transactions to support the hotel's continuing effort to deliver outstanding guest service and financial profitability.Pay rate for this position is $19.00/hrWhat will I be doing?As Night Auditor, you would be responsible for overseeing the auditing, posting...


  • Downey, United States Los Angeles County Office of Education Full time

    **About the Employer**: Welcome to the Los Angeles County Office of Education! Thank you for your interest in joining the LACOE family. We are proud of the fact that we have talented staff, excellent growth opportunities, outstanding support and an invigorating mission. The primary function of LACOE is to service and support 80 K-12 school districts along...


  • Downey, United States Kaiser Permanente Full time

    Job Summary: The Medical Social Worker II provides assessment, coordination, and implementation/evaluation of professional social services to patients and their families in order to aid them in coping with social, emotional, and economic difficulties related to medical problems or which predispose to illness. This classification is distinguished from the...


  • Downey, United States Kaiser Permanente Full time

    Job Summary: The Medical Social Worker II provides assessment, coordination, and implementation/evaluation of professional social services to patients and their families in order to aid them in coping with social, emotional, and economic difficulties related to medical problems or which predispose to illness. This classification is distinguished from the...


  • Downey, United States Kaiser Permanente Full time

    Job Summary: The Medical Social Worker II provides assessment, coordination, and implementation/evaluation of professional social services to patients and their families in order to aid them in coping with social, emotional, and economic difficulties related to medical problems or which predispose to illness. This classification is distinguished from the...


  • Downey, United States CEDARS-SINAI Full time

    Job Description The Clinical Nurse II, Oncology (per diem) is a Registered Nurse who delivers direct care to assigned Oncology patients in an ambulatory setting. Nursing care is delivered using standards of care by following approved policies and procedures. Applying appropriate decision-making skills exhibits competence in the technical, interpersonal and...


  • Downey, United States Kaiser Permanente Full time

    **Job Summary**: To perform venipuncture and skin puncture and pre-analytical and post analytical steps of laboratory testing. **Essential Responsibilities**: - Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws. - Selects the appropriate phlebotomy technique relative to the age...


  • Downey, United States Kaiser Permanente Full time

    **Job Summary**: To perform venipuncture and skin puncture and pre-analytical and post analytical steps of laboratory testing. **Essential Responsibilities**: - Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws. - Selects the appropriate phlebotomy technique relative to the age...


  • Downey, United States Kaiser Permanente Full time

    **Job Summary**: To perform venipuncture and skin puncture and pre-analytical and post analytical steps of laboratory testing. **Essential Responsibilities**: - Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws. - Selects the appropriate phlebotomy technique relative to the age...


  • Downey, United States PIH HEALTH Full time

    **Clinics**: The Patient Registration Representative II - Front Office, works under general supervision performing all tasks related to patient registration including securing and calculating upfront patient liabilities in an efficient hospitable manner. Works with the Office Team to maximize front office efficiency and perform various clerical procedures...

  • LVN II

    3 weeks ago


    Downey, United States Kaiser Permanente Full time

    Job Summary: Under the direct supervision of a Registered Nurse or physician provides nursing care in accordance with the legal scope of practice and within established standards of care, policies and procedures. Demonstrates performance consistent with the Mission, Vision and Strategic Plan of the organization. Demonstrates quality and effectiveness in...