- 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 ... for detail, strong communication skills, and a passion for quality assurance within a BPO environment. To...cars! + Health Benefits:Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 60 days of… more
- 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...HCFA paper or EDI information. * Responsible for reviewing medical records when necessary to determine if service rendered… more
- 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
- TEKsystems (Reston, VA)
- …ESSENTIAL FUNCTIONS: 50 Independently researches contractual benefits limitations exclusions and claims to assist medical professional staff in performing the ... to internal and external stakeholders without breaching confidentiality of medical information. Actively participates in monthly meetings and discussions regarding… more
- 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
- 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 ... Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical... assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines,… more
- Sedgwick (Richmond, VA)
- …until the assigned Field Case Manager arrives onsite. + Adheres to quality assurance standards. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other ... injury referral calls from clients; gathers vital case details, obtains and provides medical status updates to the customer, and assigns a Field Case Manager (FCM)… more
- 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 ... experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing… more
- CVS Health (Richmond, VA)
- …+ Assists as requested for responses for all governmental, regulatory and quality assurance provider complaints; timely and continuous reconciliation of provider ... a timely manner. Staff may be responsible for reviewing claims data and information. The Senior Network Relations Analyst...2 years' work experience in healthcare. + Experience in Medical Terminology, CPT, ICD-10 codes, etc. + Experience working… more
- UIC Government Services and the Bowhead Family of Companies (Dahlgren, VA)
- …who will be responsible for supporting a specific government program Information Assurance Security Engineer (IASE). This includes becoming familiar with the program ... and Services (PPS), Public Key Infrastructure (PKI), and DoD Information Assurance Vulnerability Management (IAVM) policies and standards. + DoD 8570 Information… more