- CVS Health (Phoenix, AZ)
- …Summary** This position will be working with a team that is responsible for quality assurance reviews of our client and pharmacy pricing execution of network ... a Fortune Company. The Sr. Analyst, you will ensure quality assurance for all client pricing implementations...all delivery systems and adjudication platforms related to pharmacy claims adjudication. You will inspect the correct application of… more
- LA Care Health Plan (Los Angeles, CA)
- …are used for internal and external reporting, the tasks including data quality assurance , process programming, specification documentation and report developing. ... national averages/percentiles published by recognized organizations such as National Committee for Quality Assurance (NCQA) and Center for Disease Control (CDC).… more
- Johns Hopkins University (Middle River, MD)
- …Specialist III_** who will be responsible for all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines. Works ... departmental management and coordinates with Clinical Practice Association, Office of Billing Quality Assurance to include review of documentation. Serves as… more
- Sedgwick (Las Vegas, NV)
- …RESPONSIBILITIES** + Performs other duties as assigned. + When not in the field, assist quality assurance team and be available for desk appraisal work as well ... with information regarding their vehicle's cost of repair estimate and explains claims /repair process + Maintains accurate vehicle's cost of repair estimate and… more
- Sedgwick (Boston, MA)
- …RESPONSIBILITIES** + Performs other duties as assigned. + When not in the field, assist quality assurance team and be available for desk appraisal work as well ... with information regarding their vehicle's cost of repair estimate and explains claims /repair process + Maintains accurate vehicle's cost of repair estimate and… more
- Adecco US, Inc. (Milwaukee, WI)
- …and indexes mail as the need arises. + Manual indexing (Exception Processing)/ Quality Assurance (QA)/Fax Processing (40%) Analyze and review using knowledge ... Preparation/Classifying (30%). + Responsible for completing underwriting and / or claims document review and audit by appropriately identifying and analyzing various… 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
- Integra Partners (Troy, MI)
- …compliance knowledge training. + Oversees all lesson plans for each application by ensuring quality assurance checks are in place and that training captures both ... program. + Develop key processes to use feedback from training assessments, the quality assurance team and leaders to design individual training plans to… more
- System One (Dayton, OH)
- …Proficient in validating internally generated data and vendor-submitted data to ensure quality assurance before submission to the state. + Vendor collaboration: ... proficiency: Capable of running SQL queries to support software quality assurance (SQA), generate summary reports, and...NCPDP transactions is an advantage but not required. + Claims adjudication systems: Knowledge of FACETS or similar … more
- Mom's Meals (Ankeny, IA)
- …posted A/R payments + Backs up claims denial team as needed + Reviews quality assurance of all referrals or updated clients from assigned state or local ... goals and metrics set by the department are followed while still providing high quality work and customer service. The Medical Billing Supervisor will also serve… more