Remote Quality Performance Lead for Claims & Audits
Gallagher Bassett
- Remote job
Gallagher Bassett is seeking a dedicated Quality Performance Lead to drive auditing, training, and continuous improvement for our General Liability and Auto Claims Captives Experience team on a nationwide basis. This role is 100% remote. You will lead audits, develop training, monitor performance, and ensure regulatory compliance with a strong emphasis on high‑severity claims. Strong claims expertise and leadership are essential for success in this role, with a broad impact on client outcomes #J-18808-Ljbffr Gallagher Bassett
- .... Whether you’re managing claims, supporting clients, or improving... ...up, stands together, and leads with purpose. Overview We are seeking a dedicated Quality Performance Lead to lead auditing, training, and continuous... .... This role is 100% remote. How You’ll Make An Impact...Remote workQualityClaimsFull timeLive outLocal areaFlexible hours
$66.46k - $129.59k
...Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's... ...Ensure compliance with all regulatory audit guidelines by adhering to roadmap of... ...proficiency - Knowledge of healthcare claim elements: CPT, CPTII, LOINC, SNOMED,...Remote workQualityClaimsWork experience placementWork at office$80k - $85k
Client Performance Manager - Workers Compensation & General... ...for overseeing the quality aspects of a specific... ...level. Ensure client’s claims reports are properly... ...‑specific operational audits; monitor client audit... ...Management. Location Remote. Must be available during...Remote workQualityClaimsFlexible hours$80k - $85k
Job Title Client Performance Manager - Dedicated Client... ...Experience Location Remote. Must be available during... ...of the Role To manage quality aspects of clients’... ...level. Ensure client claims reports are properly and... ...‑specific operational audits; monitor client audit...Remote workQualityClaimsFlexible hours$80k - $85k
Sedgwick is seeking a Client Performance Manager to oversee quality in Workers Compensation and General Liability accounts. This remote position requires availability during... ...eight years of experience, including claims management and auditing. Responsibilities include...Remote jobQualityClaims$80k - $85k
Sedgwick is seeking a Client Performance Manager to oversee quality aspects of client accounts related to Workers... ...and General Liability. This remote role requires excellent client service... ...experience and a strong background in claims management. Competitive salary ranging...Remote jobQualityClaims$150.03k - $224.25k
...Director of Global Supplier Performance & Metrics. The role is responsible for leading execution of supplier quality management strategies that... ...activities (qualification, audits, risk management, and compliance... ...processing fee, even if claimed you will be reimbursed,...Remote workQualityClaimsFull timeContract workTemporary workLocal areaWorldwideFlexible hours- Sedgwick is looking for a Client Performance Manager - Dedicated Client for their Workers... ...and General Liability sectors. This remote position entails managing client... ...of related experience, including claims management and auditing. A comprehensive benefits package and...Remote jobClaimsFlexible hours
- Remote Jobs is seeking a Lead Analyst in Quality Analytics. The role supports Molina's Quality Analytics team by designing and developing data reporting solutions for HEDIS audits and performance tracking. Candidates should have a Bachelor's degree and relevant experience...Remote workQuality
- ...committed to providing high-quality care that improves the... ...billing, support, EHR, audits, and compliance) so... ...to worry about unpaid claims ~ Rula pays you even... ...of licensed clinicians leads peer reviews, develops... ...telehealth . Work Remotely Yes MD, US...Remote workQualityClaimsContract workPart timePrivate practice
- ...Appeals Auditor (RN) to conduct Appeals reviews and analyze claims data. The ideal candidate must have an active RN license... ...medical documentation requirements and coding is essential for performing high-quality audits. This role offers a competitive salary and various...Remote workQualityClaims
$62.5k
...Senior Claims Adjuster – Casualty Location: Remote in multiple states; Hybrid only in Michigan (dependent upon... ...an ... Job Type: Full‑time Claims Quality Assurance Analyst The Claims Quality... ...initiatives, with a primary focus on claims auditing and c ... Job Type: Full‑time...Remote workQualityClaimsFull timeWork at office$135k - $170k
...transformative (to cost, quality, access and experience)... ...independent entity to lead this transformation.... ...hiring a Growth Strategy & Performance Lead to design and... ...Commercial operations audit & stabilization Conduct... ...individuals falsely claiming to represent Evio. Protecting...Remote jobQualityClaimsContract workLocal areaFlexible hours$80k - $90k
Provider Relations - Market Performance Lead Department: Provider Relations... ...improvements in clinical quality, risk adjustment, operational... ...through routine on-site and remote engagement. Conduct regular... ...efficiency. Provide billing, claims, and encounter resolution...Remote workQualityClaimsFull timeWork at office- ...support the mission of delivering high-quality at-home care, the full-time remote Medical Review Nurse will ensure... ..., manage pre-bill controls, and lead audit and appeals processes. Key... ...assurance process for surgical dressing claims, ensuring clinical completeness and...Remote workQualityClaimsFull time
- ...ensuring safe, high-quality, on-time, and on-... ...& Execution Lead all field operations... ...order development, claims management, and contract... ...subcontractor performance, safety compliance... ...standards Conduct safety audits, toolbox talks,... ...sites (often remote locations) Frequent...Remote workQualityClaimsFull timeContract workFor subcontractor
- A leading insurance provider is seeking a Claims Quality Assurance Specialist to ensure the accuracy and compliance of claims processing. The specialist will conduct audits, collaborate with claims teams, and identify areas for improvement. Candidates should have a bachelor...Remote jobQualityClaims
$28.27 - $50.48 per hour
...compliance. This role offers the flexibility to work remotely from anywhere in the U.S. Candidates should have a... ...certification. Responsibilities include conducting audits, providing coding expertise, and tracking claims. Competitive hourly pay ranges from $28.27 to $50.4...Remote jobQualityClaimsHourly pay- ...Conducting internal audits and operational quality reviews, the hybrid remote Quality Auditor will focus on claims auditing and expand to customer service interactions while... ...Analyze audit data to identify trends and performance gaps, providing data-driven recommendations...Remote workQualityClaims
$30.49 - $46.03 per hour
...by proactively resolving medical coding claim defects before billing. You will play a vital... ...accuracy and efficiency. As a remote employee, we will provide you with the equipment... ...you will find the safest and highest quality of care provided by our expert, compassionate...Remote workQualityClaimsWork at officeWork from home- A leading healthcare solutions firm seeks a Payment Integrity... ...include managing quality assurance measures and resolving... ...with healthcare auditing standards and maintain a... ...service delivery. This remote position requires strong experience in claims processing and excellent...Remote jobQualityClaimsDaily paid
- ...is looking for a Supervisor of Quality Improvement in Tampa, Florida. This... ...involves overseeing quality auditing activities and guiding a team to... ...skills and expertise in healthcare claims processing are essential. This position offers remote work flexibility with quarterly...Remote jobQualityClaimsWork at office
- CERIS is seeking a Repricing Quality Assurance Analyst to ensure accuracy, compliance, and efficiency in repricing audit data. This remote position involves reviewing multiple platforms and maintaining high standards for client satisfaction. The ideal candidate will have...Remote jobQualityClaims
- A healthcare technology firm in Boston is seeking a Quality Assurance Specialist to perform inpatient DRG validation audits. The role requires at least 5 years of experience in reviewing ICD-10 claims and an understanding of coding standards. Responsibilities include conducting...Remote jobQualityClaimsFull time
- ...an experienced Workers' Compensation Claims Auditor for a fully remote position. Ideal candidates will have... ...' compensation claims handling and auditing. This role involves conducting audits... ...actions, and participating in quality improvement initiatives. Candidates...Remote jobQualityClaims
- ...career, it's a calling MO-REMOTE Worker Type:... ...with inpatient coding and auditing. RHIT, RHIA, and CCS are... ...considered) Job Summary: Performs periodic and ongoing audits of claims to ensure accuracy of... ...(***) ***-**** HB Coding Quality Team Scheduled Weekly...Remote workQualityClaimsHourly payFlexible hoursShift workDay shift
- CorVel Corporation is seeking a Claims Quality Assurance expert to conduct audits and ensure compliance with claim handling... ...involves training, monitoring performance, and leading quality assurance initiatives. This position is fully remote and requires excellent...Remote jobQualityClaims
- ImagenetLLC is seeking a Claims Quality Analyst to ensure the accuracy and compliance of claims processing. This remote role requires 3-5 years of experience in healthcare claims,... ...experience with EZCap. The analyst will conduct audits, analyze disputes, and support training...Remote jobQualityClaims
- Integra Partners in Troy, Michigan is seeking a Claims Quality Assurance Analyst. This role involves monitoring and documenting production quality related to claims auditing and interactions within the Revenue Cycle Management (RCM) function. The ideal candidate should...Remote jobQualityClaims
- A healthcare organization is seeking a remote Billing Analyst to assist with pre-bill audits and manage patient data entry. The ideal candidate will have strong... ...interpersonal communication skills, a commitment to quality and integrity, and be adept in a collaborative...Remote jobQualityClaims
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