- Sharp HealthCare (San Diego, CA)
- …checks) provide efficient, cost-effective solutions as directed.Serve as the lead on claims testing and quality assurance activities and assisting ... investigating and responding to internal and external benefit inquiries, and supporting claims testing activities. **Required Qualifications** + 3 Years in HMO or… more
- AECOM (Philadelphia, PA)
- …+ Monitoring the contractor's quality for compliance with the contractor's approved quality control / quality assurance (QA/QC) plan + Monitoring ... orders, requests for clarification (RFI's), submittals, and other as needed + Conducting quality assurance audits + Receiving and reviewing progress reports from… more
- Covenant Health Inc. (Knoxville, TN)
- …tell the truth. + Maintains established departmental policies and procedures, objectives, quality assurance program and safety standards. + Demonstrates an ... care is required. Computer experienceand basic math skills required. Knowledge of medical terminology, claims submission, customer service is preferred. Expected… more
- Actalent (Des Moines, IA)
- …metrics, completing a minimum of 40 reviews per day post-training, and maintain quality assurance standards at 97%. + Document reviews accurately and ... of our healthcare services. Responsibilities + Conduct utilization management reviews and claims assessments using InterQual criteria and medical policy. +… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- …fax, mail, and upload correspondence and documentation as needed. + Follow established quality assurance standards and all policies and procedures. + Report and ... About The Role MagnaCare provides Utilization Review/ Case Management/ Medical Management/ Claims Review services to its clients. Care Coordinators facilitate… more
- MyFlorida (Tallahassee, FL)
- …Total Compensation Estimator Tool (https://compcalculator.myflorida.com/) Department of Health Division of Medical Quality Assurance Bureau of Enforcement ... personnel, or working as a licensed healthcare professional regulated by the Division of Medical Quality Assurance . + Bachelor's degree from an accredited… more
- Travelers Insurance Company (Las Vegas, NV)
- …Travelers' Claim Organization is at the heart of our business. By providing assurance to our customers during life's rainy days, the Travelers Workers Compensation ... you will handle all aspects of a workers compensation claims . In this role, you will learn how to...work. You will develop the technical skills needed for quality claim handling including investigating, evaluating, negotiating, and resolving… more
- CVS Health (Richardson, TX)
- …on applications development, technical requirements, code review, project deliverables, quality assurance , and software development best practices. Independently ... on applications development, technical requirements, code review, project deliverables, quality assurance , and software development best practices. Independently… more
- UIC Government Services and the Bowhead Family of Companies (Aberdeen, MD)
- …that the test data meet project's requirements and meets Government standards for quality assurance , completeness, accuracy and timeliness. + On a weekly basis, ... performs a 100% quality assurance check of data from an...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Actalent (Des Moines, IA)
- …including a minimum of 40 reviews per day post-training, and maintain a quality assurance standard of 97%. + Document reviews accurately and consistently ... team. In this role, you will perform timely utilization management reviews and claims assessments using InterQual criteria and medical policy. You will work… more
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