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
- ...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...ClaimsWork at office
$85k - $110k
...an alternative application process. Quality Assurance & Compliance Specialist Full-time Regular Technical... ...0,000.00 Annually About the Role K2 Claims Services, LLC (“K2 Claims”) is... ...preparation for carrier, client, and regulatory audits. This is a highly visible, cross...ClaimsFull timeFlexible hours- The NATIONAL COUNCIL ON ALCOHOLISM seeks a Quality Assurance Specialist to support the integrity, accuracy, and timely billing of Drug... ...services billed. You will conduct pre-billing reviews, support timely claims submission, and perform ongoing chart reviews, audits, and #J-...Claims
$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... ...of the organization. Quality Orientation Setting high standards...ClaimsContract workWork at office$25 - $35 per hour
...Howmet Fastening Systems (HFS) is seeking a Quality Tech III, Quality Specialist at our... ...and blueprints using GD&T Handle customer claims and rejections through quality portals Take... ...inspection certifications preferred Internal auditor certifications (AS9100 or ASQ CQA/CQI) a...ClaimsPermanent employmentWork at office- ...and Program Innovation, the Quality Assurance Specialist is responsible... ...the integrity, accuracy, compliance, and timely billing of Drug... ...supports timely and accurate claims submission. The Quality Assurance... ..., accuracy, timeliness, and regulatory compliance. Review...ClaimsWork at officeImmediate start
$43k - $100k
...while assessing damage or loss. You will be responsible for each claim until it is settled, traveling up to 75% of the time and... ...Qualifications High school diploma. Crop insurance experience in claims or compliance, or other ag‑related background. Analytical skills and...ClaimsFull timeLocal areaRemote work- Jobtailor is seeking a seasoned Claims Manager to oversee complex commercial claims... ...on negotiation, budget management, and regulatory compliance. You will lead investigations, verify... ...mentoring, training, and maintaining high quality standards while communicating risks to...Claims
- ...matter expert. The role focuses on researching, analyzing, and resolving complex encounter, claims, and reimbursement issues while ensuring data quality and regulatory compliance. The position requires collaboration with multiple stakeholders, oversight of encounter...Claims
- Gainwell Technologies is seeking a Claims Service Supervisor to oversee a healthcare claims processing team, ensuring accurate adjudication and regulatory compliance. You will provide leadership, coaching, and quality oversight while driving continuous improvements and...ClaimsCasual workWork at officeWork from home
$75.2k - $112.8k
..., we ensure top-notch quality in every bite, making... ...Manufacturing Department, Legal, Regulatory Affairs, Culinary and... ...with matters and claims arising out of safety... ...development and compliance, raw material usage and... ...ASQ Certified Quality Auditor certification (preferred...ClaimsRemote workFlexible hours- Responsibilities The Claims Manager supports Live Nation's operations and has primary responsibility for managing liability claims in North America. Conducts and/or oversees claim investigations and resolution of general liability, auto liability, and property damage...ClaimsWork at office
$365k
...California. The team represents major consumer product manufacturers in high‑stakes matters involving Proposition 65, regulatory compliance, private plaintiff claims, and consumer class actions. This is an excellent opportunity for an associate seeking hands‑on responsibility,...ClaimsFixed term contract- Responsibilities Provide Regulatory Leadership for Innovation & Commercialization (55%) Serve... ...formulations, supplier documentation, claims, ingredient statements/nutrition... ...Competencies Expertise in FDA regulations and compliance, with a strong focus on risk assessment...Claims
- Strategic Product Liability and Regulatory Counsel Serve as a trusted legal advisor to cross... ...reforms Counsel business teams on compliance with key regulatory authorities and frameworks... ...Experience with managing customer claims and warranties, including creating and managing...ClaimsContract work
$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...ClaimsFull timeWork at officeMonday to FridayWeekend work- 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...ClaimsFlexible hours
- ...Strategic Comp, a leading provider of workers' compensation insurance, seeks a Field Claims Specialist in Southern California. The role involves investigating and adjusting high-exposure California WC claims with a focus on settlements, reserves, and reporting. Travel...ClaimsNight shift
- The Director of Quality and R&D will lead product innovation, formulation strategy,... ...highest standards of safety, efficacy, regulatory compliance, and brand integrity. This leader will... ...regulations Ensure labeling compliance and claims substantiation Manage product...Claims
$88.85k
...Care’s mission is to provide access to quality health care for Los Angeles County's... ...purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits of claims... ...audits focuses on contractual and regulatory compliance with timeliness and appropriateness...Claims- ...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...ClaimsFlexible hours
$50.92 - $79.06 per hour
Description Supports the Risk Management, Regulatory Compliance and Patient Safety programs through investigation and analysis of potential and actual adverse events, claims, and regulatory compliance and accreditation related occurrences or deficiencies. Participation...ClaimsFull timeShift work- ...Representative in Santa Rosa, CA. The role will determine claimant eligibility for SDI benefits, conduct fact-finding interviews, process claims, and ensure accurate customer service, with hybrid telework options and standard M-F schedule. Ideal candidates will understand SDI...ClaimsRemote work
- Crawford & Company seeks a skilled claims adjuster to provide and deliver adjusting services across multiple lines of business. Roles include investigating coverage, liability, and damages, interviewing claimants, and compiling reports for clients. The position calls for...Claims
- Independent Insurance Claims Adjuster Join MileHigh Adjusters Houston as an Independent Insurance Claims Adjuster. This role offers flexibility, autonomy, and competitive compensation. Why This Opportunity Matters Demand for claims adjusters is growing due to increased...Claims
- 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...ClaimsFlexible hours
- Stance Health Solutions is seeking a Revenue Cycle Auditor to manage the revenue cycle, submit and follow up on insurance claims, and resolve payer discrepancies. The role involves analyzing accounts receivable, identifying denial patterns, and coordinating with providers...Claims
- 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
- 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...ClaimsFlexible hours
- A leading claims adjusting firm is seeking Licensed Insurance Claims Adjusters in California, MO. The role involves aiding individuals and businesses in recovering from disasters while enjoying flexible working conditions. Candidates will receive comprehensive training...ClaimsFlexible hours
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