• Senior Quality Analyst,…

    Providence (WA)
    …Directors and Officers, Employment Practices, Fiduciary, Property, Cyber, Managed Care, and Auto Claims . The Senior Quality Analyst assists the Claims ... claims environment, and respond positively to change.** **The Senior Quality Analyst performs all duties in...and propose opportunity solutions and success replication. Propose monthly audit focus topics to claims leaders based… more
    Providence (08/01/25)
    - Related Jobs

  • Data Quality & Audit Analyst…

    AmeriHealth Caritas (Philadelphia, PA)
    **Role Overview** Reporting to the Manager, the ** Senior Data and Quality Analyst** will be part of our provider network compliance and reporting team. You will ... Lead Analyst on the team, proofs work of Data Quality and Audit Analysts, and also trains...Must have previous experience working with healthcare data or claims data + Bachelor's Degree OR In lieu of… more
    AmeriHealth Caritas (07/16/25)
    - Related Jobs

  • Senior Claims Specialist

    Axis (Alpharetta, GA)
    …available upon request for candidates taking part in the selection process. **Job Description: Senior Claims Specialist** AXIS is seeking a Senior Claims ... Claims team reporting to the Manager of Casualty Claims . This position requires senior claims...Assurance - Comply with best practices measured by monthly Quality Assurance and Management Initiated Audit scores… more
    Axis (06/25/25)
    - Related Jobs

  • Senior Provider Audit Analyst

    Point32Health (Canton, MA)
    …service to our members, partners, colleagues and communities. **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of ... to everyone in our communities. At Point32Health, we are building on the quality , nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard… more
    Point32Health (07/18/25)
    - Related Jobs

  • Senior Compliance Coding Analyst…

    Houston Methodist (Houston, TX)
    …risk and identify and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of ... specific practices. Serves a subject matter expert. + Effectively communicates audit results to faculty and staff. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS**… more
    Houston Methodist (05/30/25)
    - Related Jobs

  • Claims Manager

    CHS (Clearwater, FL)
    …for Claims Department strategy, planning, staffing projection, budgeting and quality assurance and improvement. * Responsibility for final hiring decisions on ... **Overview** ** Claims Manager** **Servicing** **Health Insurance Policies or Benefits**...Quality to implement appropriate standards for accuracy and audit procedures intended to validate those standards are met.… more
    CHS (05/09/25)
    - Related Jobs

  • Manager, Claims & Insurance

    American Water (Camden, NJ)
    …wastewater services to our communities. Effective, efficient, and intelligent insurance claims management, oversight, and forecasting are essential to this mission. ... As the Claims & Insurance Manager, you will be instrumental in...are not limited to: o Compliance with applicable Internal Audit , Sarbanes-Oxley mandates and other internal policies. o Monopolistic… more
    American Water (07/01/25)
    - Related Jobs

  • Complex Claims Director, Severity

    AIG (Atlanta, GA)
    Join us as a Senior Claims Adjuster to take on...to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes , ... key responsibilities within a world - class claims function. Make your mark in Claims ...claims expert and thought leader. + As a senior member of the team , you will act… more
    AIG (05/30/25)
    - Related Jobs

  • Director, Claims Modernization,…

    Healthfirst (NY)
    …+ Assists in the development of strategic plans to ensure modern and efficient claims processing across the entire lifecycle with a focus on a unified, streamlined ... the evolution and operation of a variety of digital claims capabilities on our modernization roadmap + Analyzes project...functions + Ensures all NY state and federal compliance, audit and regulatory requirements are met + Performs other… more
    Healthfirst (07/04/25)
    - Related Jobs

  • Inpatient Clinical & Coding Specialist…

    Independent Health (Buffalo, NY)
    …knowledge and audit tips across the team. The Clinical & Coding Specialist- Senior will support the leadership in Hospital Audit in accomplishing all aspects ... fosters growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist- Senior will be responsible for reviewing coding and clinical decisions on… more
    Independent Health (07/15/25)
    - Related Jobs