Current jobs related to Claims Quality Assurance Specialist - San Jose, California - Santa Clara Family Health Plan
-
Healthcare Quality Assurance Specialist
1 week ago
San Francisco, California, United States San Francisco Health Plan Full timeJob Summary:We are seeking a highly skilled Healthcare Quality Assurance Specialist to join our team at San Francisco Health Plan. The ideal candidate will have experience in auditing daily processed claims, maintaining and reporting claim samples, and interpreting Medi-Cal and Medicare contracts.This is a hybrid position that requires on-site work in our...
-
Senior Quality Assurance Specialist
2 weeks ago
San Jose, California, United States Sky Jet Services Full timeWe're seeking an experienced Senior Quality Assurance Specialist to join our team at Sky Jet Services in San Jose, CA. This role is ideal for individuals with a strong background in quality control and assurance.About the RoleThis Senior Quality Assurance Specialist will be responsible for ensuring that products meet strict specifications and quality...
-
Quality Assurance Specialist
2 weeks ago
San Jose, California, United States Encore Industries Full timeAbout Encore IndustriesWe are a leading industrial company with over 23 years of experience in precision sheet metal and custom contract manufacturing. Our state-of-the-art facility is located in the heart of Silicon Valley, serving a diverse range of industries including technology, green power, commercial, and medical.Job OverviewWe are seeking a highly...
-
Quality Assurance Specialist
2 weeks ago
San Jose, California, United States Omega Solutions Inc Full timeOmega Solutions Inc is hiring a Quality Assurance Specialist to strengthen our testing capabilities. The estimated annual salary for this position is $110,000 - $160,000.Job DescriptionThe successful candidate will be responsible for automating tests using Fitnesse Framework, ensuring high-quality software releases. This role requires a deep understanding of...
-
Quality Assurance Specialist
6 days ago
San Jose, California, United States CathX Full timeJob OverviewCathX is seeking a Quality Assurance Specialist to ensure the accuracy and completeness of quality records. This role involves scanning and uploading documents to SharePoint online storage for retention. The successful candidate will maintain a clean and organized work area.Key Responsibilities:Organize files and records for scanning.Review...
-
Network OS Quality Assurance Specialist
1 month ago
San Jose, California, United States Diverse Lynx Full timeJob Title: Network OS Quality Assurance SpecialistLocation: San Jose, CA or RTP, NC (Raleigh)Job Description:We are seeking a skilled Network OS Quality Assurance Specialist to join our team at Diverse Lynx LLC. As a Network OS Quality Assurance Specialist, you will be responsible for ensuring the quality and reliability of our network operating system.Key...
-
Quality Assurance Specialist
1 week ago
San Jose, California, United States Partners Personnel Full timeAbout the RoleWe are currently seeking a Quality Assurance Specialist to join our team at a local plastic manufacturing facility in San Jose, California.The ideal candidate will have 1 to 3 years of experience in manufacturing and be able to read, write, and verbally communicate in English.Job ResponsibilitiesPerform dimensional inspections twice per shift...
-
Quality Assurance Specialist
1 week ago
San Jose, California, United States Trigo ADR Americas Full timeAbout the Role:Quality Assurance Specialist - Mechanical InspectionWe are seeking a highly skilled Quality Assurance Specialist to join our team at Trigo ADR Americas. As a key member of our quality assurance department, you will be responsible for ensuring the highest standards of quality and safety in our aerospace manufacturing...
-
Senior Quality Assurance Specialist
7 days ago
San Jose, California, United States Total Aviation Staffing, LLC Full timeJob OverviewTotal Aviation Staffing, LLC is seeking an experienced Senior Quality Assurance Specialist to join their team in San Jose, CA.Key ResponsibilitiesThe ideal candidate will possess strong analytical skills and attention to detail, ensuring the highest standards of quality and accuracy within the machine shop operations.Conduct thorough inspections...
-
Senior Localization Quality Assurance Specialist
1 month ago
San Jose, California, United States ACL Digital Full timeAbout the Role:We are seeking a highly skilled Senior Localization Quality Assurance Specialist to join our Localization team at ACL Digital. In this role, you will lead multiple localization quality assurance projects, ensuring the highest quality of localized content for our diverse customer base. Your technical and interpersonal skills will enable you to...
-
Senior Quality Assurance Specialist
4 weeks ago
San Jose, California, United States Cisco Systems, Inc. Full timeJob OverviewWe are seeking a highly skilled Senior Quality Assurance Specialist to join our Silicon Operations team at Cisco Systems, Inc. The ideal candidate will have extensive experience in data analytics, quality methodologies, and electronic manufacturing processes.This role requires collaboration with cross-functional teams to ensure product quality...
-
Software Quality Assurance Specialist
3 weeks ago
San Jose, California, United States Amazon Full timeAt Amazon, we're committed to delivering exceptional customer experiences through innovative products and services. As a Software Quality Assurance Specialist, you'll play a critical role in ensuring the quality and reliability of our products by developing and executing test plans, identifying defects, and collaborating with cross-functional teams.About the...
-
HVAC Quality Assurance Specialist
5 days ago
San Jose, California, United States GDM Group Full timeJob OverviewElevate Your Career with Trio Heating & AirTrio Heating & Air, a leading provider of exceptional HVAC services, is seeking an experienced HVAC Quality Assurance Specialist to join our award-winning team. In this role, you will play a crucial part in ensuring the highest quality of residential HVAC installations and repairs.As a key member of our...
-
Quality Assurance Specialist
2 weeks ago
San Jose, California, United States Lynx Software Technologies Full time**Job Summary**We are seeking a highly skilled Quality Assurance Specialist - Embedded Systems to join our team at Lynx Software Technologies. As a key member of our quality assurance team, you will be responsible for ensuring the highest levels of quality and security in our software products.You will work closely with our product teams to design and...
-
Quality Assurance Specialist
6 days ago
San Clemente, California, United States Interaction24,LLC Full timeJob Title: Quality Assurance Specialist\Estimated Salary: $60,000 - $80,000 per yearAbout the Role:We are seeking a highly skilled Quality Assurance Specialist to join our team at Interaction24, LLC in San Clemente, CA. As a Quality Assurance Specialist, you will be responsible for ensuring that our products meet the highest standards of quality and...
-
San Jose, California, United States Omega EMS Full timeJob Title: PCBA Assembler and Quality Assurance SpecialistSalary: $60,000 - $80,000 per yearAbout the Role:This position involves working closely with cross-functional teams to assemble and test PCBA's and perform quality assurance activities to ensure products meet industry standards.Responsibilities:Operate various types of assembly equipment, read and...
-
**Software Quality Assurance Specialist**
1 month ago
San Jose, California, United States MILLENNIUMSOFT Full timeJob Title – Software Quality EngineerAt MillenniumSoft, we are seeking a skilled Software Quality Assurance Specialist to join our team. Key Responsibilities:Provide independent verification of software products according to pre-approved software design requirements and specifications.Develop, maintain, and execute test cases both manual and...
-
Claims Resolution Specialist
5 days ago
San Jose, California, United States State Farm Insurance Full timeThe Claims Resolution Specialist is responsible for resolving customer claims in a fair and timely manner.Main Responsibilities:Investigate and analyze customer claims to determine liability.Communicate with customers to resolve issues and provide updates on claim status.Collaborate with team members to ensure customer satisfaction and maintain compliance...
-
Automated Quality Assurance Specialist
2 weeks ago
San Jose, California, United States Diverse Lynx Full timeAbout the RoleWe are looking for a highly skilled Automated Quality Assurance (QA) specialist to join our team. The ideal candidate will have experience with testing software applications using GoLang and TestComplete.Key ResponsibilitiesImplement QA design for errors.Implement feedback and changes whenever possible.Create visualizations that convey accurate...
-
Production Quality Assurance Specialist
7 days ago
San Jose, California, United States B&Z MANUFACTURING COMPANY INC Full timeAt B&Z Manufacturing Company Inc., we are seeking a skilled Production Quality Assurance Specialist to join our team. This role is responsible for ensuring the quality of our products by conducting inspections, audits, and other quality control activities.Job OverviewB&Z Manufacturing Company Inc. has been a leading machine shop in the San Francisco Bay Area...
Claims Quality Assurance Specialist
1 month ago
The Claims Quality Assurance Auditor plays a critical role in ensuring the accuracy, consistency, and quality of claims processing at SCFHP. This position requires strong analytical and communication skills, as well as experience in claims processing and auditing.
**Key Responsibilities:**
- Conduct audits of claims processed against established Plan guidelines and protocols
- Maintain a broad knowledge of SCFHP Medi-Cal and Medicare claims processing rules and regulations
- Responsible for maintaining a high level of accuracy and compliance with regulatory requirements
- Collaborate with Claims Analysts to resolve complex claims issues
- Provide training and feedback to Claims staff
- Monitor and oversee claims reports to ensure compliance with claims payment standards
**Requirements:**
- Associate's Degree in Business, Healthcare, or related field
- Minimum of five years of claims processing or claims auditing experience
- Prior experience with managed care plans, Medi-Cal and/or Medicare programs
- Knowledge of professional and hospital reimbursement methodologies
- AAPC Certified Professional Coder (desired)
**Working Conditions:**
- Primarily performed in an office environment
- Frequent contact with and interruptions by co-workers, supervisors, and plan members or providers
- Regular bending, reaching, and sitting or standing for extended periods
SCFHP is a leading health plan dedicated to providing high-quality care to its members. This position offers a unique opportunity to work with a talented team and contribute to the success of the organization.