Claims Quality Auditor

Job SummaryAs a Claims Quality Auditor at MetroPlusHealth, you will play a vital role in ensuring the accuracy and integrity of our claims processing system. Your expertise in claims coding, contracting, and reimbursement methodologies will be essential in identifying trends and irregularities, and recommending corrective actions to improve the claims...

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that healthcare is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.Our organization is dedicated to providing the highest quality healthcare services to...

Job SummaryThe City of New York is seeking a highly skilled Quality Assurance Auditor to join our team. As a Quality Assurance Auditor, you will be responsible for reviewing contracts, budgets, and case records to ensure compliance with program requirements.Key ResponsibilitiesConduct audits of vendor contracts and case records to identify areas of...

Job Summary The City of New York is seeking a highly skilled Quality Assurance Auditor to join our team. As a Quality Assurance Auditor, you will be responsible for reviewing contracts, budgets, and case records to ensure compliance with program requirements. You will also conduct site visits, analyze vendor forms and procedures, and provide training to...

A leading health services organization in New York City is seeking an experienced professional to fill the role of Senior Claims Quality Director at Tandym Group.In this position, the Senior Claims Quality Director will be responsible for the development and implementation of a data-driven Claims Quality Assurance and Performance oversight program to ensure...

Job SummaryMomentum Resource Solutions is seeking a highly skilled Director of Claims Quality to lead our Claims department in ensuring payment accuracy and promoting a continuous improvement culture.The ideal candidate will have a strong background in claims operations, leadership experience, and a proven track record of driving organizational and...

We are seeking a skilled Medical Bill Auditor to help us modernize medical claim auditing. As a key member of our team, you will be responsible for reviewing and analyzing medical claims, patient medical records, and automatic claim audit results to help train our machines to deliver automated audit results.Your role will be integral to our engineering teams...

Job DescriptionMetroPlus Health provides high-quality healthcare services to residents of the Bronx, Brooklyn, Manhattan, Queens, and Staten Island through a comprehensive list of products, including New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, and more. As a wholly owned...

Job Title: Senior Claims Specialist - Management Liability ClaimsThis is an exciting opportunity to join Axis Services, a trusted global provider of specialty lines insurance and reinsurance, as a Senior Claims Specialist - Management Liability Claims. We are seeking a highly skilled and experienced professional to join our North America Claims team and...

About Alaffia Health & Our MissionAt Alaffia Health, we're tackling the $500B issue of medical billing fraud, waste, and administrative burden in the U.S. healthcare system. Our team of clinicians, AI/ML engineers, and product experts is building advanced AI to reduce healthcare costs. We're a high-growth, venture-backed startup based in NYC, actively...

Our client, a leading industry player, is seeking an IT Auditor to join their team. The successful candidate will be responsible for developing and evaluating audit processes, reporting on their results, and applying established audit standards throughout the infrastructure.The ideal candidate will have a strong understanding of IT audit principles and...

Job Title: Senior AuditorThe City of New York is seeking a highly skilled Senior Auditor to join its Department of Design and Construction, Engineering Audit Office. As a Senior Auditor, you will be responsible for conducting thorough audits of construction projects to ensure compliance with Comptroller Directive No. 2, 6, and 7.Key Responsibilities:Conduct...

Job Title: Internal AuditorJoin The CSI Companies as an Internal Auditor and play a key role in ensuring the effectiveness of our internal control framework. As a seasoned professional, you will leverage your expertise to identify and mitigate risks, enhance operational efficiency, and drive business growth.About the Role:We are seeking a highly motivated...

Job SummaryThe City of New York is seeking a highly skilled Senior Auditor to join our team. As a Senior Auditor, you will be responsible for auditing partial, substantial, final, and retainage payment requisitions for construction, equipment, and related consultant services contracts.Key ResponsibilitiesAudit payment requisitions to ensure compliance with...

About the Role:We are seeking an IT Auditor/Sr. IT Auditor to join our team at Warner Music Group. As an IT Auditor, you will be responsible for executing SOX audits for our domestic and international recorded music labels and affiliates. This role will involve applying your IT audit skills, developing them further, and learning all aspects of the music...

A leading financial services firm, Tandym Group, is seeking an experienced Senior Auditor to join their Internal Audit Department. In this role, the Senior Auditor will be responsible for participating in the execution of model risk related internal audits of various complexities, executing audit work in accordance with IIA standards and IAD policies and...

Join Bloomberg's Team as an Internal AuditorBloomberg is a fast-paced technology company that requires a skilled Internal Auditor to provide independent and objective assurance to add value and improve operations. As an Internal Auditor, you will work closely with the Lead Auditors covering Bloomberg's global business, products, and services.Key...

Job Description**Job Summary**The City of New York is seeking a highly skilled Senior Auditor to join our team. As a Senior Auditor, you will be responsible for auditing construction projects to ensure compliance with Comptroller Directive No. 2, 6, and 7.Key ResponsibilitiesAudit partial, substantial, final, and retainage payment requisitions for...

Job Title: Lighting AuditorJob Summary:We are seeking a skilled Lighting Auditor to join our team at Adecco. As a Lighting Auditor, you will be responsible for conducting detailed lighting assessments across the NYC metro area, aimed at providing upgrade proposals for building owners and managers.Key Responsibilities:* Promote Energy Efficiency Programs:...

Job Title: Lighting AuditorAt Adecco USA, we are seeking a skilled Lighting Auditor to join our team. As a Lighting Auditor, you will be responsible for conducting detailed lighting assessments across the NYC metro area, aimed at providing upgrade proposals for building owners and managers.Key Responsibilities:Promote Energy Efficiency Programs by performing...