• Supervising Claims Coordinator - Hybrid

    Stanley Black and Decker (Towson, MD)
    …with logging files for litigation or other legal hold. + Preparing quarterly audit of Litigation Managers' and Safety Assurance Managers' workload and reserve ... individual to join our Legal Team as a Supervising Claims Coordinator. In this position, you will provide administrative...support to Product Liability Counsel, Litigation Managers and Safety Assurance Managers. This is a hybrid role based in… more
    Stanley Black and Decker (07/09/25)
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  • Performance Assurance Analyst

    Sedgwick (Fort Worth, TX)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Performance Assurance Analyst **PRIMARY PURPOSE** **:** To monitor claims colleague ... office file audits using the Compass tool + Presents audit results to local, regional and national management as...performance management (TPM) review meetings with national TPM and Quality leaders. + Maintains technical claims and… more
    Sedgwick (07/31/25)
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  • Healthcare Process Risk Manager (Internal…

    Grant Thornton (Los Angeles, CA)
    …Grant Thornton LLP, a licensed, certified public accounting (CPA) firm that provides audit and assurance services ― and Grant Thornton Advisors LLC (not ... and the overall effectiveness and efficiency of processes. + Oversee internal audit outsourcing and co-sourcing engagements for clients. + Manage the risk… more
    Grant Thornton (06/25/25)
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  • Claims Supervisor

    PennyMac (Fort Worth, TX)
    …+ Develop required process infrastructure, policies, procedures, and operational routines + Audit functions/ quality assurance of key processes to ensure ... of homeownership through the complete mortgage journey. A Typical Day The Claims Supervisor is responsible for providing structure and oversight to the post-sale… more
    PennyMac (06/27/25)
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  • MassHealth Regulatory Compliance & Audits…

    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 & ... CMS Medicare requirements. This role is housed within the Claims Operations & Quality Assurance ...* 5+ years in healthcare compliance, regulatory affairs, or claims audit . * Experience working with TPA… more
    Commonwealth Care Alliance (06/02/25)
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  • Executive Director of R&D Global Quality

    Otsuka America Pharmaceutical Inc. (Princeton, NJ)
    …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain clinical… more
    Otsuka America Pharmaceutical Inc. (06/13/25)
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  • Onsite Pharmacy Auditor (based in California)

    Prime Therapeutics (San Diego, CA)
    …or combined pharmacy and PBM experience to include: + 2 years of work experience in audit or quality assurance + 1 year of work experience in customer ... and professional knowledge to identify educational trends and select claims for audit in alignment to department...new ideas and work collaboratively to provide the highest quality of care and service to our members. If… more
    Prime Therapeutics (06/28/25)
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  • DRG Coding Auditor

    Elevance Health (Grand Prairie, TX)
    …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...Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge… more
    Elevance Health (07/22/25)
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  • Trade Quality Specialist

    Molson Coors Beverage Company (Golden, CO)
    …sales team and brewery. The role is responsible for delivery against the yearly audit schedule, review of quality claims filed by distributors, brewery ... part of the team that owns the regional distributor audit strategy, and acts as the liaison between the...out in the market. This position reports to Manager, Quality Assurance - Distribution & Trade. **What… more
    Molson Coors Beverage Company (07/29/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (OH)
    …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)
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