• Quality Audit for Life & Annuity Death…

    DXC Technology (Richmond, VA)
    …Minimum 2 years of experience in Life and Annuity insurance, specifically in Death Claims processing and quality assurance . + Strong understanding of ... teams to address and resolve process deficiencies. + Document and maintain quality assurance reports, records, and audit trails. + Support training… more
    DXC Technology (05/29/25)
    - Related Jobs
  • Claims Processor - Remote

    Cognizant (Richmond, VA)
    …coverage guidelines and regulations. * Experience in the analysis and processing of claims , utilization review/ quality assurance procedures. * Must be able ... - 4:30pm ET **Experience:** A minimum of 1 years claims processing is required. **Travel:** None required **About the...is required. **Travel:** None required **About the role:** As Claims Processor, you will be responsible for timely and… more
    Cognizant (08/01/25)
    - Related Jobs
  • DRG Coding Auditor

    Elevance Health (Richmond, VA)
    …at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance , or recovery auditing. + Requires at least one ... responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of.../ Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge… more
    Elevance Health (07/22/25)
    - Related Jobs
  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Richmond, VA)
    …in applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance , or clinical documentation improvement, and a ... and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims more
    Elevance Health (08/01/25)
    - Related Jobs
  • Quality Assurance Specialist

    Mass Markets (VA)
    …as a trusted partner in the industry. We are seeking a detail-oriented and analytical Quality Assurance Specialist to join our team. This role is critical in ... requires a keen eye for detail, strong communication skills, and a passion for quality assurance within a BPO environment. To be considered for this role,… more
    Mass Markets (06/13/25)
    - Related Jobs
  • Pharmacy Quality Assurance

    Elevance Health (Richmond, VA)
    …we are actively defining our innovative role in the industry. **Pharmacy Quality Assurance Specialist** **Location:** This role requires associates to be ... as required by law._ **Schedule: Monday - Friday; 8:00am-5:00pm** The **Pharmacy Quality Assurance Specialist** is responsible for evaluating the quality more
    Elevance Health (08/02/25)
    - Related Jobs
  • Spec, Quality Assurance I

    TEKsystems (Reston, VA)
    …ESSENTIAL FUNCTIONS: 50 Independently researches contractual benefits limitations exclusions and claims to assist medical professional staff in performing the review ... of medical information. Actively participates in monthly meetings and discussions regarding quality appeal research data entry and to problem solve any issues… more
    TEKsystems (07/25/25)
    - Related Jobs
  • Facility Coding Inpatient DRG Quality

    Banner Health (VA)
    …documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. ... different focuses (Facility vs Profee)._ In this **Inpatient Facility-based HIMS Coding Quality Associate** position, you bring your **5 years of acute care… more
    Banner Health (06/15/25)
    - Related Jobs
  • Clinical Account Manager - Georgia PDL - Remote

    Prime Therapeutics (Richmond, VA)
    …management activities including assurance of Service Level Agreement performance, assurance of accuracy of claims payment and administrative policies, rate ... Level Agreement performance in Care Management Centers and Shared Services, assurance of claims accuracy payment/ administrative policies, rate maximization… more
    Prime Therapeutics (07/24/25)
    - Related Jobs
  • RN Crisis Care Triage

    Sedgwick (Richmond, VA)
    …until the assigned Field Case Manager arrives onsite. + Adheres to quality assurance standards. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other ... followed and communicated to the appropriate parties and promotes quality cost-effective outcomes through communication and available resources. **ESSENTIAL… more
    Sedgwick (07/25/25)
    - Related Jobs