Remote Quality Specialist II - Audits & Compliance
Premera Blue Cross
- Remote job
Premera Blue Cross in the United States is seeking a Quality Auditor to conduct audits professionally, ethically, and objectively, applying standards and requirements to gain accurate findings across claims, enrollment, and customer service operations. This role is telecommuter-friendly and focuses on improving quality and compliance. You will develop audit plans, communicate findings, advise on corrective actions, and help resolve high-impact issues with cross-functional teams while promoting #J-18808-Ljbffr Premera Blue Cross
- ...To support quality assurance initiatives, the full-time remote Quality Specialist II will oversee compliance with audit programs, conduct audits of transactions, and collaborate with teams to identify and implement quality improvements. Key responsibilities: Conduct...Remote workFull time
- Parallon, a part of HCA Healthcare, seeks a Credentialing Processing Center Specialist II to safeguard patient well-being by ensuring verified credentials across hospitals and facilities. The role involves navigating complex regulatory guidelines and coordinating with a...Remote job
- ...organization that invests in you as a Quality Audit Specialist II? At Parallon, you come first. HCA... ...Integrity Reviews, Specialist Reviews, and Compliance Reviews, that supports precise... ...preferred NAMSS Certification preferred. Remote employees are required to live within...Remote workTemporary workWork experience placementFlexible hours
$53.13k - $85k
Serves as a member of the quality team at the national, regional or unit level. Coordinates... ...control reviews and external/internal audits. Summarizes findings and prepares... ...Job Information Title Quality Specialist II - Remote Grade 23 Work Experience - Required...Remote workFull timeTemporary workWork experience placement$50k - $65k
...DescriptionJob DescriptionRFI, LLC is hiring a Quality Specialist II to join our Quality Assurance team.... ...product moving without compromising compliance.Run the environmental monitoring... ...preventive controls.Support internal and SQF audits, and keep food safety records...SuggestedWork at office- Trillium Health Resources seeks a Quality Management Specialist II - IDD to monitor HCBS services and innovations waiver adherence during the member’s plan year. Focus is on HCBS final rule compliance and collaborative work with Care Management for quality support. The...Remote job
- Premera Blue Cross is seeking a Quality Audit professional to conduct audits and ensure adherence to standards. You will plan and communicate audit activities, maintain up-to-date knowledge of audit techniques, and document results with recommended corrective actions. The...Remote job
- Premera Blue Cross is seeking a Quality Auditor to ensure compliance and improve processes across claims, enrollment, and customer service. You will conduct audits, document findings, and drive corrective actions with cross-functional teams. You should have a high school...Remote jobWork experience placement
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- Trillium Health Resources in North Carolina is seeking a Quality Management Specialist II - IDD to ensure that HCBS services in Residential, Day... ...supervise Innovations Waiver services for final HCBS rule compliance. The role emphasizes proactive assessment, monitoring,...Remote job
- ...Resources is conducting a search for a Quality Management Specialist II - IDD. This role focuses on ensuring... ...to uphold quality and waiver compliance. The position requires Qualified Professional... ...experience in MH/DD/SA settings. Remote NC-based work is available with...Remote job
- Premera is seeking a Product & Group Configuration Quality Specialist II to audit and improve medical, dental, and pharmacy configuration quality. You will review outputs against source documents and standards, providing actionable feedback to partners to ensure accurate...Remote job
- ...to technical specifications; auditing and review of electronic clinical... ...to meet HEDIS regulatory compliance. Responsible for oversight and... ...Understanding of NCQA HEDIS quality measures and related code value... ...codes applied, including CPT II, SNOMED, LOINC, ICD, HCPCS,...Remote work
- ...focused on advancing health through innovative solutions. The Quality System Specialist II will manage corrective/preventive actions, internal audits, and customer complaints to ensure FDA and ISO compliance across the plant's operations. Reporting to the Quality Manager...
- ...growing Technical Publications Division, the full-time Quality Specialist will review technical documents for accuracy and compliance, perform content audits, and collaborate with team members, all while working remotely. Key responsibilities Review and verify technical...Remote workFull time
- ...Performing audits of insurance processing and ensuring compliance with company procedures, the full-time Quality Control Specialist will review processes, assess internal controls, and prepare audit reports while working remotely. Key responsibilities Conduct quality...Remote workFull time
- Quality Validation Specialist, Outpatient Coding Remote - US Machinify is a leading healthcare intelligence... ...outpatient coding validation audits to ensure accuracy, consistency, compliance, and adherence to client,... ..., EAPGs, CPT, HCPCS Level II, and ICD-10-CM coding...Remote workTemporary workFlexible hours
$63k - $90k
...independent, second-level quality reviews using an “audit-the-auditor” approach. As a Senior Verification Specialist, you’ll reassess completed... ...independent quality and compliance reviews of member and provider... ...this role ~ Fully remote options from most US...Remote workFull timeWork at officeImmediate startFlexible hours- ...Performing in-depth system and procedural audits, the full-time remote Quality Assurance Specialist III will manage audits of service... ...enrollment functions, ensuring compliance and accuracy while mentoring less... ...a Quality Assurance Specialist II Preferred: ECA Certified Quality...Remote workFull timeWork at office
- ...Quality Systems SpecialistWe are seeking an individual to support Quality Systems management by executing various... ...documentation maintenance, supplier quality, and audit program administration. This role ensures compliance with ISO standards, cGMPs, and customer...Monday to FridayAfternoon shift
- ...Health is seeking a Coding Quality Specialist 3 to support PM&R Musculoskeletal... ...Rehabilitation coding. This remote role emphasizes accurate documentation review, coding audits, and education for providers... ...across coding, compliance, and clinical teams. CPC certification...Remote job
- Centene Corporation seeks a quality improvement professional to review delegated entities for compliance with quality, service performance and utilization, and perform credentialing reviews and medical record audits. The role includes on-site reviews of physician offices...Remote job
- ...Managing client audits and internal assessments, the Quality Audit Specialist will work in a hybrid role based in Blue Bell, PA, primarily remotely, while ensuring compliance with clinical trial regulations and improving audit processes. Key responsibilities Host and...Remote work
$27.79 per hour
Remote Inpatient Coding Quality Specialist Join Our Team and Earn a $5,000 Sign-On Bonus! Schedule: Monday-Friday, 4... ...the coding quality reviews. Prepare audit summaries for reports for distribution to facility CFOs and compliance. Monitor assigned coding quality review...Remote jobHourly payContract workTemporary workPart timeReliefLocal areaVisa sponsorshipRelocation packageMonday to Friday- Recover Medical Group is seeking a Quality Assurance and Improvement professional to support regulatory compliance, audits, licensing, reporting, and quality initiatives across... ..., 40 hours weekly, with options for fully remote work or working from one of our sites. #J-...Remote jobFull timeLocal area
- Newly Weds Foods is seeking a Corporate Quality Assurance Associate II to support quality and food safety... ...will lead QA activities, participate in audits, and help align processes with GMP/... ...with four days on-site and one day remote weekly, and requires 25% travel. #J-...Remote work
- ...Cross is seeking an Enrollment Oversight and Quality Specialist to manage complex enrollment, eligibility, billing changes, and audits with strong customer service. You will coordinate across teams, ensure regulatory compliance, and support strategic partners. The role...Remote jobDay shiftAfternoon shiftEarly shift
- Inotiv in Rockville, MD is seeking a Quality Assurance Auditor II with a B.S. in chemistry or life... ...years in GLP environments, including auditing experience. The role requires strong... ...reports, maintaining SOPs, and ensuring compliance with FDA and EPA GLPs and...
$67.19k
...in days) to receive an alert: Claims Quality Auditor II Job Category: Claims Department: Core... ...works closely with the Claims Quality Auditing Manager. The Claims Quality Auditor II... ...departments i.e. Payment Integrity and Claims Compliance. This position works to ensure claims...Full time- ...employees who are dedicated to safety and quality. We are a trusted partner to more... ...Job summary: The Quality Auditor II reviews GLP studies for completeness, compliance, concurrence, and accuracy. The... ...throughout the auditor's quality audit team. Additionally, the auditor...Worldwide
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