Pharmacy Claims Auditor - Quality & Compliance Specialist
City of Lincoln
The City of Lincoln is seeking a full-time Claims Auditor in Ridgefield Park, NJ. The ideal candidate will have a solid background in Long-Term Care Pharmacy and will be responsible for preparing audit responses, reviewing claims, and ensuring compliance. This role requires excellent problem-solving skills, MS Office proficiency, and the ability to communicate effectively with diverse stakeholders. Join our team to contribute to quality improvement and customer service excellence. #J-18808-Ljbffr City of Lincoln
$32 per hour
FuseGlobal is seeking a Quality and Compliance professional in Edgewater, New Jersey. This role focuses on ensuring adherence to food safety initiatives and specifications via training and development of quality professionals. The ideal candidate will have a strong background...SuggestedHourly pay$20 - $24 per hour
...#claimsauditor, #qualityimprovement, #pharmacy Employee Type Full Time Required Degree... ...school Phone 908.241.6337 Ext. 4017 CLAIMS AUDITOR We are seeking a Claims Auditor with QI... ...identify billing errors, discrepancies, and compliance issues. Obtain, validate, and organize...ClaimsFull timeLocal areaMonday to Friday- ...celebrate their potential, and help spark brighter futures. Summary: Seeking a detail-oriented and mission-driven Quality Improvement and Compliance Specialist to support NeuSpark PDS in maintaining adherence to OPWDD regulations, Medicaid standards, and internal policies...SuggestedFor contractorsWork at officeMonday to Friday
- ...Job Description Job Description Quality Assurance Compliance Specialist Allendale, NJ Lynkx Staffing LLC specializes in placing talented professionals in the Biotechnology, Pharmaceutical and Medical Devices industries in New Jersey. This position will report into...SuggestedNight shift
$51.8k - $75k
RSC Insurance Brokerage, Inc. is seeking a detail-oriented Audit Specialist to conduct thorough audits of claims files, ensuring compliance and accuracy. The ideal candidate will have 4-6 years of claims or audit experience, a bachelor's degree preferred, and strong analytical...Claims- Alltrista Plastics LLC, located in Pennsylvania, seeks a Coordinator, Quality Compliance to ensure quality management practices across production. Responsibilities include managing complaints, overseeing audits, and maintaining supplier quality standards. The ideal candidate...
- S:US is seeking a Quality Improvement Associate to enhance and maintain quality standards across the organization. In this role, you will conduct site visits, participate in audits, and develop training for staff on quality improvement processes. Ideal candidates will possess...Flexible hours
- GlaxoSmithKline is seeking a quality professional in Pennsylvania to support product and process compliance activities. The role involves managing change control, investigating deviations, and ensuring quality systems remain inspection-ready. Candidates should have an...
- A healthcare provider in New York is seeking a Quality Specialist responsible for monitoring and improving quality standards in healthcare delivery. The role involves reviewing client charts, analyzing data, and collaborating with staff to enhance care coordination. Qualified...
- A reputable compliance assurance organization in New Jersey is seeking a candidate to ensure compliance through detailed review of records... ...in aligning personal objectives with broader site goals, contributing to the overall quality team efforts. #J-18808-Ljbffr Mindlance
- A New York-based compliance organization is seeking a Quality Improvement Specialist to support agency-wide performance improvement efforts. This role involves monitoring compliance with regulations, conducting audits, and analyzing data to enhance service delivery for...Full timeMonday to Friday
- Independence Blue Cross (Independence) is seeking a fully remote Certified Pharmacy Technician Auditor to conduct audits on pharmacy claims, ensuring accurate provider payments and identifying potential fraud, waste, or abuse. The role requires an extensive understanding...ClaimsRemote job
- Independence Blue Cross is seeking an Auditor, Payment Integrity to conduct pharmacy claim audits ensuring accurate provider payments while detecting fraud and improving audit processes. This fully remote role requires a Certified Pharmacy Technician with at least four...ClaimsRemote jobWork at office
- RPMGlobal in Totowa, New Jersey, is seeking a Training Specialist to support quality and manufacturing initiatives. The role involves developing... ...training programs, assessing training needs, and ensuring compliance with CGMP regulations. Ideal candidates will hold a...
- ...Pennsylvania is seeking an Aging Services Specialist for the Department of Aging. This full-... ...community programs meet safety and quality standards for older adults. Responsibilities... ...maintaining knowledge of regulations, reviewing compliance, and preparing summaries of findings. A...Full timePart timeRemote work
$121.79k - $183.65k
Medication Regulatory Compliance Specialist - PharmD required On-Site Allied Health - Pharmacy New York, NY ID: 1160187_RR00118962 Full-Time/Regular NYU Langone Health... ...patient outcomes through a rigorous focus on quality that has resulted in some of the lowest...Full time- Metropolitan Jewish Health System, Inc. is hiring for a quality assurance position in New York City focused on care management documentation and compliance. This role will ensure that care management records meet regulatory standards through development of auditing tools...
- Downtown Boulder Partnership is seeking a Quality Assurance Officer responsible for reviewing clinical treatment and documentation while implementing improvements. This role ensures compliance with industry standards and enhances the quality of care provided by the agency...
- ...SpecialtyRx is a Long-Term Care pharmacy providing pharmaceutical services... ...delivering personalized care and quality pharmacy services. NOTICE: SpecialtyRx... ...insurance information, resolving claim rejections, and maintaining compliance with payer requirements. This role...ClaimsLocal area
$97.1k - $114.4k
The Underwriting Quality Auditor ensures the integrity, consistency, and compliance of underwriting practices across all lines of business. This role evaluates underwriting... ...Qualifications Background in quality assurance, claims, compliance, or knowledge of multiple insurance...ClaimsFull timeWork at office$47 - $56 per hour
Senior Auditor Quality - CCCR Job Locations US-Remote ID 2026-18251 Category Audit - Healthcare... ...for ensuring that the audited claims meet quality standards necessary to generate... ...clients. Quality assurance emphasizes compliance with established procedures, accuracy...ClaimsRemote jobFull timeWork at officeImmediate startFlexible hours- Job Summary The Pharmacy QA Specialist plays a critical role in the pharmacy... ...accuracy, completeness, and quality of pharmacy-related... ...documentation quality Ensure compliance with applicable state, federal... ...process over 200,000 insurance claims annually for leading...ClaimsRemote jobTemporary workWork at officeWork from home
$32 per hour
...20 years) Initial term: 12 months (position expected to run longer) Schedule: M-F 8am - 5pm About This Role Guardian of Quality and Compliance by Design following the quality requirements and deliverables for Food Safety initiatives in raw material specifications (mainly...Hourly pay- Quality Specialist - Cosmetics & OTC Compliance Location: hybrid (preferred) remote (possible for experienced self-starter meeting qualifications) Employment Type: Full-time, long-term Contract/1099 Evermark is a newly formed beauty and personal care company bringing together...Long term contractFull timeContract workRemote work
$60k - $75k
...Job Description Job Description Compliance Specialist – Affordable Housing Queens, NY | Full-Time | About the Company EqualAccess is... ...preparing properties for agency audits. Think of this role as part quality control, part compliance navigator, and part regulatory...Full timeInterim roleWork at officeLocal area- ...Duties and Responsibilities: Enforces ILA’s Corporate Compliance Plan as per OMIG regulations Conducts regular monthly... ...response to identified problems. In conjunction with the Quality Assurance Specialist reviews ILA programs and documentation “on-site” in...Immediate start
- ...Job Description Job Description Job Description Compliance Specialist Summary Description Reporting to the Assistant... ...responsibility for the Compliance Specialist is to assist in achieving quality compliance with the requirements of the WSFSSH’s external...Work experience placementWork at officeFlexible hours
- ...Job Description Job Description Senior Auditor Employment Type: Full Time, Mid-level... ...legal staff by conducting medical claims data analysis, forensic investigations, financial... ...to honesty, professionalism, and quality work. Here at CGS we value honesty through...ClaimsFull timeFlexible hours
$42.29k
...Payable and Reporting (DAPR) is responsible for the employee expense claim processing, auditing, and data entry. The Office of Fiscal... ...fill one (1) Clerical Associate III to function as an Expense Auditor, who will: Audit and approve payments for staff members carfare...ClaimsPermanent employmentWork at office- ...Job Description Job Description Auditor Employment Type: Full-Time, Mid-Level Department... ...records, financial records, healthcare claims, tax records, correspondence, policies,... ...to honesty, professionalism, and quality work. Here at CGS we value honesty through...ClaimsFull timeWork experience placementInterim roleWork at officeLocal areaFlexible hours
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