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

QA Claims Auditor

$64.87k - $90k

Argonaut Management Services, Inc

Farm Family specializes in farm and ranch protection with a wide range of products including flexible farm packages, business owner policies, commercial package, workers compensation, commercial auto and select personal auto coverage. Farm Family is a leader in serving the Northeast and Mid-Atlantic markets and is pursuing growth across the U.The Farm Family entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc.

The Quality Improvement job family serves the claims operation in a variety of capacities, most of which are carried out through specialized, technical expertise. The primary functions of this job family are comprised of quality claim audits and quality assurance to maintain claims guidelines, consistent processes, level of quality, etc., Other key functions of the Quality Improvement job family may be improving process and procedures while maintaining technical bulletins, procedures, policies, practices, guidelines, and official records for the business area.

This is a 100% in-office position. Candidates must be able to work on-site at a designated company office during standard business hours.

Conduct and document claim audits in the designated audit system within established timelines, completing a minimum of three claim file audits per day.

Evaluate claim files for coverage, liability, estimates, reserving, documentation, and compliance with internal standards, regulatory requirements, and quality expectations.

Analyze audit results and perform focused audits on specific trends as needed to identify gaps and opportunities for improvement.

Provide clear and constructive feedback to claims staff and leadership.

Escalate critical findings and provide immediate feedback to leadership when urgent action is needed on a claim.

Participate in internal calibration activities within the Quality team to ensure scoring consistency.

Partner with leadership to support training initiatives and process improvements.

Minimum of four years of direct property claims handling experience, with emphasis on complex, highseverity commercial property losses

Bachelor's degree in a related field

Field claims experience with property inspections and estimate preparation

Experience handling liability claims

Familiarity with Guidewire and Athenium auditing platforms

If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at View phone number on click.appcast.io.

We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program - including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.

Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the QA Claims Auditor in Albany, NY vacancy
  •  ...services company is seeking an experienced Inpatient Medical Coding Auditor to perform coding audits and ensure accurate provider...  ...such as RHIA, RHIT, or CCS, and proficiency in MS-DRG coding, claims interpretation, and Microsoft Office. Strong communication and... 
    Claims
    Work at office
    Remote work
    Flexible hours

    Humana

    Albany, NY
    5 days ago
  •  ...Job Description Job Description Senior Auditor Employment Type: Full Time, Mid-level Department: Financial Services CGS...  ...who will assist the district legal staff by conducting medical claims data analysis, forensic investigations, financial damages, statistical... 
    Claims
    Full time
    Flexible hours

    Contact Government Services, LLC

    Albany, NY
    a month ago
  • $71.1k - $97.8k

     ...community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records...  ...medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-... 
    Claims
    Bi-weekly pay
    Contract work
    Temporary work
    Apprenticeship
    Work at office
    Remote work
    Work from home
    Home office
    Monday to Friday

    Humana

    Albany, NY
    1 day ago
  •  ...Job Description Job Description Senior Auditor Employment Type: Full-Time, Experienced Department: Financial   CGS is seeking...  ...entities, and assets. -Analyze large and complex healthcare claims datasets to identify fraud, waste, and abuse patterns. -... 
    Claims
    Full time
    Flexible hours

    Contact Government Services, LLC

    Albany, NY
    16 days ago
  • $50k - $100k

     ...Auditor Employment Type: Full-Time, Mid-Level Department: Financial CGS is seeking a highly skilled Auditor to provide general auditing...  ...of data such as bank records, financial records, healthcare claims, tax records, correspondence, policies, other documentary evidence... 
    Claims
    Full time
    Work experience placement
    Interim role
    Work at office
    Local area
    Flexible hours

    Contact Government Services LLC

    Albany, NY
    4 days ago
  • $70k - $75k

     ...Best Workplaces in Financial Services & Insurance Attorney Auditor ** This is a fully remote position, and candidates residing...  ...this or other roles. Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating... 
    Claims
    Local area
    Remote work
    Work from home
    Flexible hours

    Sedgwick

    Albany, NY
    4 days ago
  • $84.78k - $131.41k

     ...Salary Range: $84,783.00 - $131,414.00 The Senior Internal Auditor will work closely with management to better understand and respond...  ...review of evidence that either supports or refutes the System's claim of compliance as it related to these areas. The Senior Internal... 
    Claims
    Work at office
    Shift work

    Albany Med

    Albany, NY
    2 days ago
  • $13 per hour

     ...Auditor Auditor positions are located within DMDD, Bureau of Medical Review, Durable Medical Equipment, and Medical Supplies Prior...  ...for mailing within required timeframes. Performing medical claims pricing for medical pended claims. Reviewing invoices, applying... 
    Claims
    Weekly pay
    Work at office
    Monday to Friday
    Flexible hours
    Shift work

    Nexus Staff

    Albany, NY
    1 day ago
  •  ...Job Description Job Description Investigative Auditor Employment Type: Full Time, Mid-Level Department: Finance   CGS is...  ...and audit financial transactions, accounting systems, healthcare claims,  reimbursement data, procurement records, grant expenditures,... 
    Claims
    Full time
    For contractors
    Interim role
    Work at office
    Flexible hours

    Contact Government Services, LLC

    Albany, NY
    16 days ago
  •  ...Hancock Claims Consultants specialize in Ladder Assist and Property Inspection Services, collaborating directly with numerous insurance agencies for efficient claims management. At Hancock, we are at the forefront of claims resolution services, offering nationwide... 
    Claims
    Permanent employment
    Contract work
    For contractors

    Hancock Claims Consultants Technicians

    Albany, NY
    1 day ago
  •  ...Description Job Description SGI Global is seeking an Investigative Auditor to provide investigative support services to the United States...  ...and investigation of civil fraud matters involving False Claims Act and other civil violations, namely, healthcare fraud,... 
    Claims
    For contractors
    Interim role
    Work at office
    Local area

    SGI Global, LLC

    Albany, NY
    14 days ago
  •  ...A leading insurance claims adjusting firm in the City of Troy, New York, is seeking Independent Insurance Claims Adjusters. This role offers the chance to help clients recover from disasters while enjoying flexibility and competitive compensation. Candidates should be... 
    Claims
    Flexible hours

    MileHigh Adjusters Houston

    Albany, NY
    1 day ago
  • A leading insurance claims adjusting firm in the City of Troy, New York, is seeking Independent Insurance Claims Adjusters. This role offers the chance to help clients recover from disasters while enjoying flexibility and competitive compensation. Candidates should be... 
    Claims
    Flexible hours

    MileHigh Adjusters Houston

    Albany, NY
    4 days ago
  • $42.46k

     ...responsible to the Director of Insurance and performs various dutiesrelated to the processing of insurance applications, billings and claims. ESSENTIAL FUNCTIONS:1. Communicates with insured members (active and retirees), beneficiaries of insured members,attorney’s,... 
    Claims
    Local area
    Work from home

    CSEA Inc

    Albany, NY
    2 days ago
  • $106.9k - $131.67k

    Position InformationNY HELP: NoAgency: Health, Department of Title: Information Systems Auditor 2 - 283Occupational Category: Financial, Accounting, AuditingSalary Grade: 27Bargaining Unit: PS&T - Professional, Scientific, and Technical (PEF)Salary Range: From $106898 to... 
    Permanent employment
    Full time
    For contractors
    Work at office
    Remote work
    Visa sponsorship
    Shift work

    State of New York, USA

    Albany, NY
    3 days ago
  • $21 - $24 per hour

     ...Specialist to join our client and their growing healthcare team. This role is responsible for ensuring accurate medical coding, timely claims processing, insurance follow-up, and reimbursement management. The ideal candidate will possess strong knowledge of medical... 
    Claims
    Full time

    Fusco Personnel, Inc.

    Albany, NY
    23 days ago
  •  ...POSITION SUMMARY: The Insurance Claims Specialist receives, investigates, negotiates, reports, and documents personal and commercial insurance claims. This position requires the review and understanding of insurance policies, direct client contact, and diligent... 
    Claims
    Work at office
    Remote work
    3 days per week

    Amsure

    Albany, NY
    5 days ago
  • $147k - $195k

     ...level associate to join our growing Transactional Liability Practice. Our team represents insurance companies in a wide variety of claims arising under insurance policies covering mergers and acquisitions transactions, tax matters, and contingent liability risks. We are... 
    Claims
    Work at office
    Flexible hours

    Harris Beach Murtha

    Albany, NY
    1 day ago
  • Job Description Job Description *Applicants MUST submit a cover letter with resume to be considered. *This position will require in-office presence. Hybrid work schedules may be possible based on specific job duties and consistent with ESD policy. * Minorities, ...
    Work at office

    Empire State

    Albany, NY
    6 days ago
  •  ...Title: Auditor Location: 99 Washington Ave (One Commerce Plaza) Albany, NY, 12210 Duration: 24 Months Work Hours: Full-Time, Monday-Friday, 9:00am-5:00pm Job Description: Examine, analyze, and interpret accounting records for the purpose of giving... 
    Full time
    Monday to Friday

    InterSources

    Albany, NY
    1 day ago
  • $19.2 - $28.3 per hour

     ...Residential Energy Auditor At CLEAResult, we lead the transition to a sustainable, equitable, and carbon-neutral energy-efficient future for our communities and our planet. We do that by creating a people-first culture built on trust, accountability, and transparency... 
    Hourly pay
    Contract work
    For contractors
    Work experience placement
    Work at office
    Local area

    CLEAResult

    Albany, NY
    2 days ago
  •  ...Job Summary: We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must be CPC and CRC certified with strong risk adjustment coding... 
    Work at office
    Remote work

    ClinDCast LLC

    Albany, NY
    1 day ago
  • $22.5 per hour

     ...systems (Elation or Candid preferred) Verify patient eligibility and benefits including coordination of benefits Identify and resolve claims processing issues, including pre-submission errors, and generate appeals or reprocess claims as needed Communicate effectively with... 
    Claims
    Full time
    Work at office
    Local area
    Remote work

    Workit Health

    Albany, NY
    2 days ago
  • $50k - $55k

     ...Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Representative, Auto | Property Damage PRIMARY PURPOSE OF THE ROLE: To analyze and process low to mid-level auto and transportation... 
    Claims
    Contract work
    Work at office
    Local area
    Flexible hours

    Sedgwick

    Albany, NY
    4 days ago
  •  ...Job Description Job Description   Join Davies Risk Services as a Premium Auditor — No Experience Required! Are you a self-starter who thrives on independence, loves working with numbers, and enjoys meeting new people? Do you have a curious mind, strong communication... 
    For contractors

    Davies Risk Services

    Pine, NY
    1 day ago
  • $100k

     ...seeks self-motivated individuals with experience in surveillance and mobile investigations to assist in researching insurance fraud claims involving monetary, bodily injury, theft, and property damage claims. We are currently hiring Surveillance Agents to conduct... 
    Claims
    Hourly pay
    Full time
    Currently hiring
    Flexible hours

    Marshall Investigative Group

    Albany, NY
    2 days ago
  • $18 - $21 per hour

     ...patient scheduling and records Schedule and confirm appointments for multiple providers in the office File patient insurance claims and follow up on outstanding claims, verification of benefits and explanation of coverage Post insurance and patient payments and... 
    Claims
    Daily paid
    Full time
    Work at office
    Local area

    Bartram Family Dental Care

    Delmar, NY
    3 days ago
  •  ...consequential structural shift in a generation. Carriers that deploy AI as a system — across every value stream from quoting through claims — will capture significant five-year transformation value. Those that deploy it as point solutions will strand most of that value.... 
    Claims
    Full time
    Live in
    Work at office
    Local area
    Shift work

    Accenture

    Albany, NY
    3 days ago
  • $16 - $23.71 per hour

     ...patient scheduling and records Schedule and confirm appointments for multiple providers in the office File patient insurance claims and follow up on outstanding claims, verification of benefits and explanation of coverage Post insurance and patient payments and... 
    Claims
    Hourly pay
    Daily paid
    Full time
    Work at office
    Local area

    Heartland Dental

    Delmar, NY
    4 days ago
  • $22.3 - $35.2 per hour

     ...Receivables (AR) Team Lead assists with daily operations of the accounts receivable team, ensuring accurate and timely processing of claims, including denials and the maximization of cash flow. This role is responsible for optimizing AR processes and supporting the... 
    Claims
    Hourly pay
    Temporary work
    Work at office
    Local area
    Flexible hours

    Cardinal Health

    Albany, NY
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to QA Claims Auditor. Be the first to apply!