- Transdev (Lombard, IL)
- …insurance, short-term disability, voluntary long-term disability. Principal Duties and Responsibilities + Claims Quality Assurance (QA) + Responsible for ... or watch an overview video athttps://youtu.be/ilO5cv0G4mQ About the Role: The Claims Specialist will assist the Director of Workers Compensation in overseeing… more
- Cognizant (Trenton, NJ)
- …and coverage guidelines and regulations + Experience in the analysis and processing of claims , utilization review/ quality assurance procedures + Must be able ... business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical**... Processors to join our growing team. The **Medical** ** Claims Processor** is responsible for the timely and accurate… more
- JBS USA (Russellville, AL)
- …with customer relations and complaint procedures ( claims ) + Working alongside the quality assurance team to develop an understanding of how all the roles ... **Description** 2026 Quality Assurance Management Trainee About us: JBS USA is a leading global provider of diversified, high- quality food products,… more
- General Dynamics Information Technology (Menands, NY)
- …Trust/Other Required:** None **Job Family:** Professional Engineering **Skills:** Healthcare Claims , Quality Assurance (QA),Structured Query Language (SQL) ... determine the possibility of adding test cases to the Quality Assurance Regression (QAR) baseline + Add...TECHNICAL SKILLS: + 837 (I, P and D) Medical Claims testing experience + Knowledge of X12 + Experience… more
- Cognizant (Augusta, ME)
- …1 year of Facets experience. + Experience in the analysis and processing of claims for payments, utilization review/ quality assurance procedures. + Excellent ... and able to multi-task successfully? If so, please apply today! The Claims Processor, you will ensure accurate and timely adjudication of professional and… more
- Cognizant (Nashville, TN)
- …* 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/ quality assurance procedures. * Must be ... claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist, you will be responsible for timely and accurate… more
- Commonwealth Care Alliance (Boston, MA)
- …will not be considered at this time._** Position Summary: Reporting to the Director, Claims Operations & Quality Assurance , the Regulatory Compliance & ... Medicaid) and CMS Medicare requirements. This role is housed within the Claims Operations & Quality Assurance team and works closely with Cognizant (TPA) to… 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 ... 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 (Hanover, MD)
- …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
- Sharp HealthCare (San Diego, CA)
- …reasonableness checks). Providing efficient and cost-effective solutions as required.Oversees all claims testing and quality assurance activities and ... and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit… more