Senior Hospital Claims Quality Reviewer
1199seiu
1199SEIU in New York is seeking an experienced Hospital Claims Processor to cross-train staff and support the Fraud & Abuse findings in the Hospital Claims Department. You will review complex claims and ensure timely processing across multiple programs. The role requires strong Excel skills, excellent written and verbal communication, and the ability to work under strict timelines. Collaboration with QA and management is essential. #J-18808-Ljbffr 1199seiu
- ...Claims Processing Specialist Monitor claims processing system... ...) to ensure functionality of Hospital claims processing (i.e electronic... ..., system enhancements and review performance of automated software... ...and reported by the Claims Quality Assurance Department....QualityClaims
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- .... Our agentic AI works claims end-to-end, from portal... ...We're looking for a Senior Accounts Receivable Specialist... ...Conduct QA reviews of permanent BA work during... ...the transition and flag quality gaps before the team exits... ...experience working in a hospital system or physician...QualitySeniorClaimsPermanent employmentFull timeWork at officeImmediate startFlexible hours
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$130k - $160k
...Description Senior Revenue Accountant-(Revenue Cycle... ..., and reporting of hospital revenue, which includes... ...compliance, including reviewing hospital contracts to... ...Support investigation into claims patterns, payor mix... ...environment and deliver quality outcomes. Ability to...QualitySeniorClaimsFull timeWork at officeLocal area$150k - $180k
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Senior consultant, health & welfare benefits (remote)... ...United States.PBGH advances quality, drives affordability... ..., alongside and with review from senior leadership.... ...employer demographics, claims, utilization, cost,... ...Transparency in Coverage, Hospital Price Transparency). Translates...QualitySeniorClaimsRemote jobMinimum wageFor subcontractorWork at officeShift work$130k - $150k
...with you! Position Overview The Senior Data Analyst will be a key... ...sense of ownership over the quality of their deliverables, writes... ...Voluntary benefits including FSA, Hospital indemnity, Accident and... ...encounter any communications claiming to be from DrFirst that seem...QualitySeniorClaimsTemporary workRemote workFlexible hours$73.01k
...Senior Property Claims Representative To assure the consistent application of company procedures and practices in commercial, residential... ...and positive overall effect on the company. To provide quality service to insureds and aid in the retention of business. To...QualitySeniorClaimsWork at officeRemote workWork from home- ...real estate litigation, including consumer claims directly against the firm’s clients.... ...court for routine and contested hearings, reviewing incoming litigation and developing case... ...appeals. Communicate with clients to ensure quality representation and implementation of all...QualitySeniorClaimsWork experience placementWork at officeRemote work
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...outstanding service for all assigned accounts. Uphold high-quality standards for underwriting accuracy and compliance. Qualifications... ...the advantages of robust loss prevention strategies, proactive claims management, and efficient RMIS solutions. Exceptional...QualitySeniorClaimsWorldwide$142k - $169k
...Senior Product Designer: This Senior Product Designer role is ideal for a designer... ...Engineering, and help raise the bar for design quality and process across the team. This role... ...correspondence from an individual claiming to represent Narmi please let us know immediately...QualitySeniorClaimsImmediate startRelocationRelocation package- ...and underwriting entities. Oversee litigation issues related to claims, ensuring proper adjustment and settlement within policy limits... ...improvements to reduce costs, enhance revenue, and ensure quality, safety, and customer service standards are met. Manage and support...QualitySeniorClaims
- Purple Drive Senior Data Architect Share Contractual NYC PDT - 6602 8-17 06/07/2024 Overview... ...Source to Target Mappings (STTM's) Data Quality Rules and Validations - Compare the... ...plus to have a knowledge around Provider / Claims space. Knowledge on CI/CD process Purple...QualitySeniorClaims
- ...and Gynecology provides high-quality, evidence-based care to a diverse... ...) or Manhattan (Tisch Hospital). Our team values collaboration... ...Gynecology is seeking a full-time Senior Obstetrician to serve on... ...standards Participate in the review of adverse events and near-...QualitySeniorFull timeTraineeshipShift work
- ...Hmong Chinese Language Document Reviewer Employment Type: Full Time, Mid-Level Department... ..., rules to show cause, proofs of claim, motions for summary judgment, dismissals... ...commitment to honesty, professionalism, and quality work. Here at CGS we value honesty through...QualityClaimsFull timeWork at officeFlexible hours
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...who will take pride in being the person responsible for that claim. As Senior Content Marketing Manager, you’ll own our content strategy and... ...our virtual and live events, hold the line on exceptional quality, and ensure everything you’re creating contributes to marketing...QualitySeniorClaims- Serving as a Senior Guidewire Developer, the full-time remote position... ...and ensure technical quality throughout the development lifecycle... ...architecture and security standards Review designs and configuration... ...configurations Proficiency in claims and billing, ratebook and...QualitySeniorClaimsFull timeRemote work
$95.9k - $148.9k
...and timely issuance and servicing of high-quality policies. Responsibilities Underwrite... ...results, while maintaining awareness of claims activity and providing underwriting input... ...to underwriting governance through peer review, referral support, and the technical training...QualitySeniorClaimsTemporary work- ...General Counsel of Clinical Operations & Risk Management to advise hospital operators on patient care risk issues and lead an enterprise-... ...You will supervise outside counsel, shape strategy to reduce claims, and work with the Legal Department's teams to manage matters from...SeniorClaims
$150k - $200k
...Senior Actuary - Pricing (P&C Insurance | Remote (U.S.) We’re partnering with a leading... ...closely with Product, Pricing, Underwriting, Claims, and Finance to align actuarial work with... ...the rate filing lifecycle, ensuring quality and consistency in output What We’re Looking...QualitySeniorClaimsRemote work$172.67k
...Long Island Rail RoadJob Title: Senior Manager Elevator and Escalator... ...maintenance contractors, quality control & assurance measurements... ...Technical Scope of Work (TSOW) reviews, system monitoring including data... ..., accident investigation and claims investigations.Select, develop...QualitySeniorClaimsContract workFor contractors$142.38k - $195.49k
...representing Brex at design events, portfolio reviews, and on relevant social platforms.... ...and evaluate candidate portfolios, craft quality, systems thinking, and collaboration... ...email with a brex.com domain. Any outreach claiming to be from Brex via other sources should...QualitySeniorClaimsFull timeWork at officeImmediate startRemote workWork from home$119.32k - $136.36k
...STV is seeking a Senior Scheduler to join our Project Controls team... ...schedule development, schedule review, cost management support, risk... ...with clients, and elevate the quality of project controls... ...) Evaluate change order and claim-related schedule impacts and provide...QualitySeniorClaimsFor contractorsFlexible hours$45k - $70k
...Utilization Management Nurse Reviewer plays a crucial role in healthcare... ...control costs, and maintain quality care. \3 Key Responsibilities... ...life insurance options; hospital indemnity, critical illness,... ...process over 200,000 insurance claims annually for leading national...QualityClaimsTemporary workWork at officeRemote workWork from home$160k - $195k
...Senior Integration Engineer Overview Duet empowers Nurse Practitioners to run and... ...you're a builder who understands how data quality and pipeline reliability translate directly... ...clinical, scheduling, billing, and claims data from source systems into our platform...QualitySeniorClaimsLocal area
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