Hospital Claims Auditor - Compliance & Process Quality
6AM City, LLC
6AM City, LLC is seeking a Hospital Claims Auditor located in California, Missouri. This role is responsible for ensuring the quality of claims processes and adherence to regulations. Main duties include auditing processed claims, training Claims Examiners, and conducting research on claims issues. Candidates should have a High School Diploma, three years of relevant experience, and expertise in coding and medical terminology. Strong organizational and communication skills are essential. Join us to make a difference in healthcare compliance. #J-18808-Ljbffr 6AM City, LLC
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Hospital Claims Auditor - Compliance & Process Quality in California, MO vacancy
- Blue Shield of California is seeking a Quality Assurance Auditor to join the Internal Audit team in California. In this role, you will conduct compliance audits and ensure adherence to quality standards and contractual agreements. The position requires at least 7 years...QualityWork at office
- Job Summary Monitors the processing and reconciliation of incoming electronic medical records, importing of prepay claims and records, and generating other operation reports related... ...implementing, deactivation, monitoring, quality assurance, and reporting of prepay edits....QualityClaimsFor contractorsWork experience placement
- ...eligibility for State Disability Insurance benefits, ensuring quality customer service and compliance with laws. This full-time position requires in-office... ...Key responsibilities include conducting interviews, processing claims, providing training, and identifying fraud. #J-18808...QualityClaimsFull timeWork at office
- 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....QualityClaims
$365 per month
...to produce accurate, high quality work products, manage... ...state and Office policies. Process vendor payments, prepare claim schedules, resolve invoice... .... The California State Auditor’s Office is not an E-Verify... ..., ensuring accuracy and compliance. You have strong verbal...QualityClaimsPermanent employmentTemporary workSummer workWork at officeRemote workWeekend work$64.38k - $96.58k
...Health is seeking a remote Risk Adjustment Compliance Auditor to support auditing and compliance... ...to ensure the coding accuracy and quality of the data submitted to CMS. Works with... ...Maintains current knowledge of CMS audit processes, risk adjustment regulations, and...QualityRemote jobFull timeLocal areaMonday to FridayFlexible hours$68.5k - $104.1k
...customer experience through efficient, high-quality chat-based claims and inquiry support. This leader manages... ...enhance team effectiveness, ensures compliance with claim handling standards, and drives expert execution of processes in a fast-paced, service-focused environment...QualityClaimsBase plus commissionWork from home$88k - $132k
...Systems Analyst serves as the end-to-end process subject matter expert for Zuora, owning... ...partners closely with IT to ensure data quality, integrity, and seamless integration across... ...that support business growth and compliance. Job Description And Requirements Who We...QualityRemote workHome office$105k - $125k
...add a Workers’ Compensation Claims Unit Manager to their California... ...claims, ensuring compliance with state regulations, company... ...provide technical direction, quality assurance, and performance management... ...regulations, disability rating processes, and settlement procedures....QualityClaimsRemote jobPermanent employment- ...Insights The Director for Quality and Risk Adjustment is... ...medical management, claims payment, consumer... ...integrated delivery systems, hospitals, clinics, and other... ...as needed to drive process change across the organization... ...for regulatory compliance and organizational alignment...QualityClaims
$102.96k
...function, including insurance, claims management, risk control, and... ...unit (including people, processes, and technologies) that is structured... ...type incident costs. Ensures compliance of both Team Member and guest... ...of the organization. Quality Orientation Setting high standards...QualityClaimsContract workWork at office$3,844 - $4,811 per month
...for an auditing role focusing on the legality and validity of claims. Responsibilities include auditing claims for payment from the... ...organizational and communication skills. This position supports state compliance with regulations. Salary ranges from $3,844.00 to $4,811.00 per...ClaimsContract work- ...the general supervision of the Claims Director, provide an... ...education program to advance the quality and production level of the Claims... ...and overall managed care processes. Proficiency and experience in... ...learning programs is a plus. Compliance Providence is an Equal Opportunity...QualityClaims
$70 - $110 per hour
...enables you to deliver high-quality patient care while... ..., EHR, audits, and compliance) so that you can focus... ...by any nursing board, hospital or other credentialing... ...to worry about unpaid claims No-show protection: Rula... ...credentialing process. With your help, we can...QualityClaimsFor contractorsPrivate practice- Reports To: Vice President of Food Safety, Quality & Regulatory Compliance Travel: Up to 50% seasonal travel... ...authority for day‑to‑day quality and process improvements that do not require... ...dashboards and KPI reporting, including claims reduction, leaker rates, seal...QualityClaimsSeasonal workWork at officeImmediate start
$125.4k - $181.42k
Sr. Manager, Quality Assurance and Compliance page is loaded## Sr. Manager, Quality Assurance... ..., guidelines, tools and processes for monitoring, reviewing... ...to include Audit the Auditor mechanism to achieve organizational... ...operational areas such as claims, configuration, provider...QualityClaimsFor contractorsRemote work$85.7k - $128.54k
...a clinical team and ensuring compliance with CMS regulations. Responsibilities... ..., including pre‑service and claims reviews. Supervise licensed... ...turnaround times. Promote quality patient care outcomes while... .... Implement and maintain UM processes, including medical claims review...QualityClaimsRemote jobLocal area- ...President, Business Development • Claims Department: Claims Services... ...by centralized governance, compliance, and technology... ...efficiency while maintaining the high‑quality investigative services and specialized... ...complex procurement processes and multi‑stakeholder decision...QualityClaimsContract workWork at officeFlexible hours
$75k - $80k
Regulatory Compliance Specialist @ Astrix Our client, a leading manufacturer... ...Collaborate with Sales and Quality Assurance teams to meet... ...Experience in Food Industry/ Food Processing/Food Manufacturing.... ...Prop 65, and Nutritional/Health Claims. Experience with NLEA guidelines...QualityClaimsFull timeWork at officeMonday to FridayWeekend work$110k - $130k
...uptime, improving maintenance quality and operational efficiency,... ...management, repair operations, compliance, fleet readiness, and... ...field operations experience, process discipline, vendor management... ...Operations, Safety, Finance, Claims, and Launch teams Safety & Compliance...QualityClaimsLocal area- Overview The Managed Care Compliance Specialist is responsible for assisting with the implementation... ...not limited to AB1455 and Medicare Claims Processing Guidelines. This position maintains... ...-Sinai is a leader in providing high-quality healthcare encompassing primary care,...QualityClaimsContract work
- ...caseload involving vehicle warranty claims under California's Song-... ...throughout the litigation process. Attend hearings, depositions... ...surrounding jurisdictions. Maintain compliance with court deadlines and... ...while delivering high-quality legal representation. Qualifications...QualityClaimsPermanent employmentFull timeInterim roleWork at officeRemote workWorldwideFlexible hours
$44.42 - $64.27 per hour
...coordinate care, remove barriers, and improve quality of life for some of the most medically... ...Coordination: Visit participants in hospitals or skilled nursing facilities (SNFs) as... ...manage authorizations to streamline claims processing. Interdisciplinary Team Collaboration:...QualityClaimsHourly pay$25.38 - $36.76 per hour
SHPCA SCAN Health Plan is seeking a Quality Auditor to conduct compliance audits across various health plan operations. This role ensures quality standards, compliance with regulatory requirements, and identifies areas for improvement to enhance our member and provider...QualityClaimsRemote jobHourly payWork at office$160k - $180k
Director of Food Safety and Quality Assurance|POM Wonderful# Director... ...program with emphasis on compliance, risk mitigation, continuous... ...yield impact from quality holds, claim rates, micro compliance (%... ...management for new capital projects, process, equipment, formulation,...QualityClaimsFull timeContract workWorldwideShift work- ...healthcare data: eligibility files, claims, enrollment lists,... ...Operations (Risk Adjustment & Quality) will support the execution and... ...operational performance, maintain compliance with regulatory requirements,... ..., and encounter submission processes to identify and address...QualityClaimsWork at office
$21.35 - $32.56 per hour
...them according to established processes and procedures; respond to... ...reportsInitiate and process customer claims and disputes; distribute... ...highest levels of safety and quality, including ensuring clean and... ...managers should also ensure compliance across their teamsProtect CPSG...QualityClaimsTemporary workWork at officeImmediate startShift work- ...Patient Services Supervisor - Hospital Billing and Follow Up . The... ...Monitoring staff productivity, quality, and adherence to... ...Ensuring timely follow-up on unpaid claims with insurance companies, government... ...the budget and goal setting processes. Research and compile...QualityClaimsFull timeWork experience placementWork at officeNight shift
$100k - $115k
...improvement. Together, these qualities fuel our ability to deliver world... ...benefits, wellness, compliance, and leave of absence administration... .... Reviews, audits, and processes weekly enrollment and monthly... ...information for Workers’ Compensation claims and to coordinate compliance...QualityClaimsFull timeWork experience placementWork at officeLocal areaWeekend work- ...a 459-bed, acute care hospital in in Orange, Calif.,... ...Health. The incumbent will process urgent, routine, pre-... ...timeliness, ensuring compliance with clinical... ...authorization data for claims adjudication. The role... ...efficiency, and high-quality patient care by supporting...QualityClaimsMonday to FridayShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Hospital Claims Auditor - Compliance & Process Quality. Be the first to apply!
Related searches
- remote auditor California, MO
- field auditor California, MO
- medical records auditor California, MO
- remote nurse auditor California, MO
- compliance auditor California, MO
- medical claims auditor California, MO
- sales auditor California, MO
- safety auditor California, MO
- inventory auditor California, MO
- data auditor California, MO