Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Claims Quality Auditor - Regulatory Compliance

Lsmamso

A leading healthcare organization is seeking a Quality Control Auditor – Claims Management to ensure accuracy and compliance in claims processing. The role involves auditing claims activities, identifying trends, and ensuring adherence to federal and state regulations. Candidates should have substantial experience in managed care claims auditing with a focus on detail and regulatory standards. Preferred qualifications include relevant degrees and certifications. This position supports operational improvement while minimizing financial risk. #J-18808-Ljbffr Lsmamso

Vacancy posted 20 hours ago
Similar jobs that could be interesting for youBased on the Claims Quality Auditor - Regulatory Compliance in California, MO vacancy
  •  ...JOB SUMMARY The Quality Control Auditor – Claims Management is responsible for performing detailed audits of claims processing activities to ensure accuracy, regulatory compliance, and adherence to contractual, coding, and reimbursement requirements within the Managed... 
    Claims
    Work at office

    LSMA Management, Inc.

    California, MO
    20 hours ago
  •  ...Shield of California is looking for an Operational Quality Services Specialist, Associate to join their Medi-Cal...  ...team. This role involves performing audits on claims processing and ensuring compliance with regulatory requirements. Candidates should have at least 1 year... 
    Claims
    Work at office
    Remote work

    Blue Shield of California

    California, MO
    3 days ago
  • $102.96k

     ...function, including insurance, claims management, risk control, and...  ...type incident costs. Ensures compliance of both Team Member and guest...  ...performed in accordance with regulatory compliance requirements such...  ...on other components. Quality Orientation: Setting high standards... 
    Claims
    Contract work
    Work at office

    Chumashcareers

    California, MO
    4 days ago
  •  ...role that requires someone who can navigate detailed claims analysis with finance leadership one hour and walk a...  ...on site surveys and implement recommendations Ensure compliance with all insurance-related regulatory requirements and support audit processes Requirements... 
    Claims
    Work at office

    Vaco by Highspring

    California, MO
    4 days ago
  • MS ACSC Management Services Inc is seeking a Claims Compliance Analyst to support regulatory compliance activities. This role includes managing complaint investigations, analyzing legal changes, and collaborating with various teams to ensure compliance with regulations.... 
    Claims

    MS ACSC Management Services Inc

    California, MO
    1 day ago
  •  ...Description JOB SUMMARY The Compliance Coordinator – Claims Management is responsible for supporting regulatory compliance, audit readiness, and reporting functions within the Claims Department of the Managed Services Organization (MSO). This role coordinates internal... 
    Claims
    Work at office

    LSMA Management, Inc.

    California, MO
    1 day ago
  • $75k - $80k

     ...Regulatory Compliance Specialist @ Astrix Our client, a leading manufacturer of food products, is...  ...Approval Program. Collaborate with Sales and Quality Assurance teams to meet customer and...  ...COOL, Prop 65, and Nutritional/Health Claims. Experience with NLEA guidelines and... 
    Claims
    Full time
    Work at office
    Monday to Friday
    Weekend work

    Astrix Inc

    California, MO
    20 hours ago
  • Your Role The Medi‑Cal Operations team ensures claims are processed accurately and in a timely manner. The Operational Quality Services Specialist, Associate reports to...  ...revisions to policies and procedures to comply with regulatory changes and train internal staff or... 
    Claims
    Full time
    Work at office
    Local area

    Blue Shield of California

    California, MO
    3 days ago
  •  ...A leading claims adjusting company in California is seeking Independent Insurance Claims Adjusters to join their team. This is a dynamic career opportunity where you will help individuals and businesses recover from disasters. Whether you are an experienced adjuster or... 
    Claims
    Flexible hours

    MileHigh Adjusters Houston

    California, MO
    4 days ago
  •  ...limited to: benefits administration, administrative duties, conducting New Employee Orientation, handling of worker’s compensation claims, unemployment claims, employee verifications, employment, i.e. qualifying applicants, references, and background testing. Positon supports... 
    Claims

    Lhmc

    California, MO
    20 hours ago
  • $25.38 - $36.76 per hour

    The Quality Auditor - Enrollment will perform routine and targeted operational quality audits across health plan operations including but not limited to Enrollment to ensure compliance with regulatory requirements, internal policies, contractual obligations, and operational... 
    Hourly pay
    Work at office
    Remote work

    SHPCA SCAN Health Plan

    California, MO
    4 days ago
  • $25.38 - $36.76 per hour

    SHPCA SCAN Health Plan seeks a Quality Auditor - Enrollment to conduct operational quality audits across its operations, ensuring compliance with regulatory standards and policies. This position involves monitoring accuracy, identifying areas for improvement in member and... 
    Remote job
    Hourly pay

    SHPCA SCAN Health Plan

    California, MO
    4 days ago
  • Capstone Logistics in California is seeking a Vendor Compliance Auditor to ensure the quality and compliance of incoming loads. This role involves monitoring shipments to identify violations and documenting findings through photographs and reports. The ideal candidate... 
    Shift work
    Weekend work

    Capstone Logistics

    California, MO
    1 day ago
  •  ...to "Saving Lifestyles" by providing high‑quality patient care in a collaborative and...  ...background in medical billing, insurance claims processing, and patient account management...  ...patients with billing inquiries. Maintain compliance with HIPAA, coding guidelines, and... 
    Claims
    Work at office

    Summit Orthopedic Specialists

    California, MO
    1 day ago
  • $21.2 - $34.69 per hour

     ...experience in handling homeowner, commercial, or auto liability claims. Candidates must be able to work 8am-5pm Pacific time zone...  ...of violations of the laws with the Office of Federal Contract Compliance Programs. To view the FMLA poster, click "here". This poster summarizing... 
    Claims
    Remote job
    Contract work
    Currently hiring
    Work at office
    Visa sponsorship
    Work visa

    Allstate Insurance Company

    California, MO
    2 days ago
  • A leading staffing firm in insurance is seeking a Claims Assistant Manager to oversee the claims lifecycle and drive improvements within...  ...workflows, and cultivating key relationships while ensuring compliance. Candidates should have over 3 years of claims experience and managerial... 
    Claims

    Insurance Relief

    California, MO
    2 days ago
  •  ...IS IT TIME FOR A CAREER CHANGE? INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? This is your chance to join a thriving industry with endless opportunities for growth... 
    Claims

    MileHigh Adjusters Houston

    California, MO
    20 hours ago
  • MileHigh Adjusters Houston is looking to hire an Independent Insurance Claims Adjuster in California, United States. This position offers flexibility, autonomy, and competitive compensation. The demand for claims adjusters is rising due to storm-related events, and licensed... 
    Claims
    Flexible hours

    MileHigh Adjusters Houston

    California, MO
    20 hours ago
  • A leading insurance claims organization is seeking Independent Insurance Claims Adjusters in California, MO. This role offers the chance to make a significant impact on clients' lives while enjoying a flexible career path and competitive compensation. Candidates should... 
    Claims
    Flexible hours

    MileHigh Adjusters Houston

    California, MO
    4 days ago
  • A leading insurance claims adjusting company in Missouri seeks Independent Insurance Claims Adjusters. This role is vital in aiding recovery efforts for clients affected by disasters, providing a rewarding career with flexibility and competitive compensation. You will... 
    Claims

    MileHigh Adjusters Houston

    California, MO
    20 hours ago
  • A national insurance adjuster company is seeking Independent Insurance Claims Adjusters to join their team in California, MO. This role offers a dynamic career path with flexibility and competitive compensation. The company provides comprehensive training to equip new... 
    Claims
    Flexible hours

    MileHigh Adjusters Houston

    California, MO
    20 hours ago
  • A claims adjusting company is looking for Independent Insurance Claims Adjusters in California. This role offers the opportunity to make a positive impact in people's lives by assisting with recovery from disasters. Ideal candidates will be licensed adjusters or willing... 
    Claims
    Flexible hours

    MileHigh Adjusters Houston

    California, MO
    3 days ago
  • $56.7k - $94.9k

    Blue Cross Blue Shield of Michigan seeks Claim Representatives I, II, and III in California. These positions involve verifying insurance coverage, investigating claims, and facilitating return-to-work processes. Candidates should have a bachelor’s degree and relevant experience... 
    Claims

    Blue Cross Blue Shield of Michigan

    California, MO
    3 days ago
  • A leading contents restoration provider in Missouri is seeking a dedicated Project Manager to oversee insurance claims from initiation to completion. The ideal candidate will manage project schedules, maintain records, and communicate regularly with clients and field teams... 
    Claims

    Blue Kangaroo Packoutz

    California, MO
    3 days ago
  • Kemper is looking for a Special Investigator 1 based in California, responsible for field and desk investigations of insurance claims. The role involves analyzing evidence to support our Special Investigative Unit and claims organization, and it serves as a career pathway... 
    Claims
    Remote job

    Kemper

    California, MO
    4 days ago
  •  ...comprehensive client information, enabling conflict checks, ensuring regulatory compliance, and documenting the preliminary scope of representation....  ...Information: For matters involving insurance coverage or claims 4. Medical Information Release: For personal injury or... 

    Genie AI, Inc.

    California, MO
    3 days ago
  • $26.49 - $50.24 per hour

     ...Field Auto Appraiser for a remote territory-based role. This position involves creating detailed damage estimates for material damage claims and negotiating settlements. The ideal candidate must have skills in auto estimating and auto insurance claims. The role requires... 
    Claims
    Remote job
    Hourly pay

    National General

    California, MO
    3 days ago
  • Chumashcareers is seeking a dedicated Risk Manager to oversee the risk management team. This role includes managing insurance and claims, ensuring compliance with regulations, and fostering a safe work environment. Candidates should have a Bachelor's degree and five years of... 
    Claims

    Chumashcareers

    California, MO
    3 days ago
  •  ...conducting various types of investigations related to insurance claims, including surveillance and fraud detection. The ideal...  ...Candidates should expect to work independently and meet deadlines while providing high-quality results. #J-18808-Ljbffr J T Becker & Co Inc
    Claims
    Flexible hours

    J T Becker & Co Inc

    California, MO
    3 days ago
  • AvonRisk, a leading specialty risk manager based in California, is seeking a full-time Claims Adjuster. This role involves investigating and analyzing insurance claims, assessing vehicle damage, and determining appropriate liability. The ideal candidate should possess... 
    Claims
    Remote job
    Full time

    AvonRisk

    California, MO
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Claims Quality Auditor - Regulatory Compliance. Be the first to apply!