as the liaison for claims issues and all other communication, Create and analyze system QA reports to ensure the integrity... requires in-depth knowledge and understanding of claims processing functions. Ability to analyze and interpret fee schedules...
are/are not met. Evaluates claims for conflict of interest and criteria appropriateness. Works within established timeframes set by program... review prior to return to the client. Serves as an additional level of QA and clinical knowledge/review for cases...
Full-Service Reviewer (QA Analyst) On behalf of a leading national restoration company with over 300 franchise... locations across North America, we are seeking a highly skilled and analytical Full-Service Reviewer to join their remote Claims...
allegiance to the United States Duties Provides administrative oversight of the Quality Assurance (QA) Program. Examines... discrepancies, prepares trend charts, and facilitates discussions with personnel at financial or QA meetings...
, and operations team · Abides by the Standards of Ethical Coding as set forth by AHIMA · Maintains appropriate QA/QI... recent experience in auditing inpatient facility or Outpatient facility claims. Advanced knowledge of CPT,, HCPCS, ICD-10...
of tools to fight fraud, waste, and abuse in health care claims. The ideal candidate is proactive, comfortable working... to skill development across the team Collaborate with Cross-functional teams - Works closely with product, QA, UX, DevOps...
Management Lead, mentor, and develop engineering teams including software engineers, cloud/integration engineers, SRE, QA... for enterprise applications (EHR integrations, care management tools, analytics platforms, claims/EDI systems, digital front door...
with a disability during the recruitment, assessment, and selection process. If you need an accommodation related to your disability... inquiries received via ProShop Help Desk for claims, imprint, account maintenance, and other order questions. Maintain ticket...
integrations between BillingCenter and external systems (e.g., policy, claims, payment vendors, general ledger, third-party APIs... accuracy and seamless E2E billing lifecycle Testing & Quality Assurance: Write unit tests and support QA teams...
disciplined pricing, margin management, and deal governance. Collaborate with production scheduling, procurement, QA... problem resolution (service issues, claims, quality/spec questions) while maintaining customer confidence and long-term...
, vendor invoicing and claims issues. Coordinates with back office the audits, reconciliation and other processes that govern... the regular deliverables such as vendor invoices, QA, transaction processing Provides service support related to the...
, and operations team · Abides by the Standards of Ethical Coding as set forth by AHIMA · Maintains appropriate QA/QI... experience in auditing outpatient facility claims. Advanced knowledge of CPT,, HCPCS, ICD-10 coding and CMS billing policies...
The Director of Quality & Regulatory will guide the full Quality organization-including QA, QC, lab operations... customer, regulatory, and accreditation audits Support regulatory needs including label review, claims, and documentation...
Onboard and train all new QA hires. New QAs will be ready for integration into the ops team when the following criteria... as a resource for team members regarding operational questions, concerns, and problem-solving. Provide backup support to QA...
and experience with responsibilities such as project correspondence, documentation, timely notice of changes and claims, negotiation... recovery plans for non performing projects QA/QC for project documentation and CPP.b requirements. Project turnover...
medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll..., Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance...
preventative measure is documented. Determines if customer claims are valid based on complaint evidence and works to minimize NWF... to assure the correct department is identified. Determines validity and scope of claims are accurate to minimize NWF financial...
operational integration controls, including standardized workflows, QA checkpoints, exception-handling rules, and human-in-the..., and regulatory requirements (e.g., HIPAA, CMS). Familiarity with claims management, contract negotiation, and compliance tools...
and obtain sign offs prior to delivery to the DEV and QA teams. Perform handoff walkthroughs of model and S2T to the DEV team... and participate in design review sessions for any refinements as necessary. Perform handoff walkthroughs of model and S2T to the QA...
promotional and advertising material for adherence to approved product claims and regulatory compliance. Serve as the RA lead... and work in partnership with Product Development, Manufacturing and QA/QC to ensure overall compliance with US, Canadian...