• Quality Audit for Life & Annuity Death…

    DXC Technology (Richmond, VA)
    …Minimum 2 years of experience in Life and Annuity insurance, specifically in Death Claims processing and quality assurance . + Strong understanding of ... teams to address and resolve process deficiencies. + Document and maintain quality assurance reports, records, and audit trails. + Support training… more
    DXC Technology (05/29/25)
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  • Medicare/Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    011250 CCA- Claims Job Description **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance , the Claims Sr. Analyst ... and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance , this role is responsible for the end-to-end… more
    Commonwealth Care Alliance (05/31/25)
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  • Complex Claims Director, Severity

    AIG (Atlanta, GA)
    …referral point for colleagues . + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes , ... Join us as a Senior Claims Adjuster to take on key responsibilities within a world - class claims function. Make your mark in Claims Our Claims teams are… more
    AIG (05/30/25)
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  • Payment Integrity: Reimbursement Policy Invoice…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …BS/BA degree preferred or equivalent experience or training + Minimum of 5 years claims audit/ quality assurance experience in healthcare required + Strong ... Director of Professional Reimbursement Strategy, the Payment Integrity Reimbursement Policy Quality Assurance (QA) Analyst is responsible for completing invoice… more
    Blue Cross Blue Shield of Massachusetts (06/22/25)
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  • Manager, Claims Management

    Walmart (Bentonville, AR)
    …determine validity of claim and ensuring settlement or denial of the claim Manages quality assurance reviews to improve claims handling procedures by ... future business needs to develop innovative strategies to improve efficiencies evaluating claims quality and processes through standardized reviews and audits… more
    Walmart (07/15/25)
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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 & ... Medicaid) and CMS Medicare requirements. This role is housed within the Claims Operations & Quality Assurance team and works closely with Cognizant (TPA) to… more
    Commonwealth Care Alliance (06/02/25)
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  • Quality Review and Audit Advisor - Express…

    The Cigna Group (Bloomington, MN)
    …diploma or GED required + 2+ years of experience in Operations, Benefits and/or Benefit/ claims testing, quality assurance , or similar roles required + ... **POSITION SUMMARY** The Quality Review and Audit Advisor is responsible for...implementations, benefit changes, and enterprise projects on time. The Quality Review and Audit Advisor will collaborate with various… more
    The Cigna Group (06/23/25)
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  • Claim Analyst IV (Lexington), Professional…

    AIG (Boston, MA)
    …decisions on the portfolio. + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes, ... Join us as a Claims Analyst IV to take on key responsibilities within a world-class claims function. Make your mark in Claims As a Claim Analyst IV, you will… more
    AIG (07/10/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Seattle, WA)
    …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
    Elevance Health (07/17/25)
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  • Sr. Manager, Provider Contract and Pricing Testing

    CVS Health (Hartford, CT)
    assurance projects. + 5+ years of experience in provider contract testing, claims adjudication systems, quality assurance , or related functions. + 5+ ... with extensive experience in provider and contract testing, test automation, and quality assurance . You will be responsible for managing a team of quality more
    CVS Health (06/18/25)
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