Claims Quality Auditor jobs in Massachusetts
Claims Quality Auditor audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Being a Claims Quality Auditor makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Additionally, Claims Quality Auditor typically reports to a supervisor or a manager. The Claims Quality Auditor gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Claims Quality Auditor typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Claims Quality Auditor jobs
Performance Quality Auditor I
- Elevance Health
-
Woburn, MA
FULL_TIME
-
Location: This is a remote position. The ideal candidate will live within 50 miles of an Elevance Health PulsePoint office location.
The Performance Quality Auditor I is responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.
How You Will Make An Impact- Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.
- Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.
- Tracks and trends audit results, providing feedback to management.
- Identifies and reports on systemic issues which create ongoing quality concerns.
- Generates monthly reports of audit findings, supports clients with issues identified and develops reports to assist management with information requested.
- Associates at this level conduct routine audits, generally related to a single function on a single systems platform for a single line of business.
- Requires high school diploma or equivalent (GED); minimum 2 years experience with the company in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector); or any combination of education and experience which would provide an equivalent background.
- Working knowledge of insurance industry and medical terminology and relevant systems and proven understanding of processing principles, techniques and guidelines strongly preferred.
- Ability to acquire and perform progressively more complex skills and tasks in a production environment strongly preferred.
- Proficient in MS Office preferred.
- Prior experience processing claims strongly preferred.
- Experience with CAS and FlexCare systems preferred.
Locations: California; Colorado; Nevada; New York;
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, nondiscriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
- 4 Days Ago
Quality Auditor C
- G & F Precision Molding Inc
-
Fiskdale, MA
FULL_TIME
- Job Description-Quality Auditor 3rd Shift G & F Precision Molding Inc., Fiskdale, MA, is growing! We are agile, innovative, customer-centric, and our goal is to provide specialized, creative solutions...
- 4 Days Ago
Senior Quality Assurance Auditor
- Parexel International Corporation
-
Billerica, MA
FULL_TIME
- Join Parexel's team of changemakers as we help advance healthcare throughout the globe, all while keeping the patient at the heart of everything we do.At Parexel, we are a leading Clinical Research Or...
- 1 Month Ago
Compliance Quality Auditor
- Cohere Health
-
Boston, MA
FULL_TIME
- Remote Company Overview: Cohere Health is illuminating healthcare for patients, their doctors, and all those who are important in a patient’s healthcare experience, both in and out of the doctors offi...
- 1 Month Ago
Clinical Quality Assurance Auditor
- MVG Consulting Services
-
Braintree, MA
FULL_TIME
- Roles and Responsibilities Clinical Quality Assurance Auditor will be responsible for: Schedule, prepare, conducts and reports assigned audits of the Client’s projects and operational processes in acc...
- 2 Months Ago
MA - 1099 Property Claims Adjuster
- Copper Claims Services, Inc.
-
Boston, MA
FULL_TIME
- 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA. Copper Claims Services excels in providing custom claims solutions fo...
- 20 Days Ago
Claims Quality Auditor jobs at Popular Companies
Quality Auditor
- Plastipak Holdings
-
Jackson Center, OH
- As a Plastipak Quality Auditor, you audit systems and processes as they relate to our Quality program. You play a key ro...
- 6/12/2024 12:00:00 AM
Quality Auditor
- ResourceMFG
-
Jacksonville, FL
- summary ResourceMFG is now hiring Quality Auditors in Lafayette! Pay and Hours: 2nd Shift: 2:30pm-11pm-$20/hr Job Descri...
- 6/11/2024 12:00:00 AM
Quality Auditor
- Texas Children's Hospital
-
Bellaire, TX
- Job Summary We are searching for a Quality Auditor - Benefits, Contracts, Fee Schedules Configuration/Testing - someone ...
- 6/11/2024 12:00:00 AM
Quality Auditor
- Loma Linda University Health
-
Loma Linda, CA
- Job Description Job Summary: The Quality Auditor will be responsible for auditing departmental workflows and functions, ...
- 6/11/2024 12:00:00 AM
Quality Auditor
- Kruger Products | Produits Kruger
-
Memphis, TN
- POSITION SUMMARY The Quality Technician will be responsible to ensure that all quality assurance program requirements ar...
- 6/11/2024 12:00:00 AM
Quality Auditor
- Catalent Pharma Solutions
-
Madison, WI
- **Quality Auditor** **Position Summary:** Catalent is a global, high-growth, public company, and a leading partner for t...
- 6/9/2024 12:00:00 AM
Quality Auditor
- Flextronics
-
Salt Lake City, UT
- Job Posting Start Date 04-26-2024 Job Posting End Date 06-26-2024Flex is the diversified manufacturing partner of choice...
- 6/8/2024 12:00:00 AM
Quality Auditor
- Mauser Packaging Solutions
-
York, PA
- JOB DESCRIPTION Responsibilities Performs quality assurance testing as required. Reviews production orders or schedules ...
- 5/23/2024 12:00:00 AM
About Massachusetts
Massachusetts is the 7th-smallest state in the United States. It is located in the New England region of the northeastern United States and has an area of 10,555 square miles (27,340 km2), 25.7% of which is water. Several large bays distinctly shape its coast. Boston is the largest city, at the inmost point of Massachusetts Bay, and the mouth of the Charles River.
Despite its small size, Massachusetts features numerous topographically distinctive regions. The large coastal plain of the Atlantic Ocean in the eastern section of the state contains Greater Boston, along with most of the state's po...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$50,287 to $61,639
Most Popular Cities in Massachusetts for Claims Quality Auditor Jobs
What does a Claims Quality Auditor do?
Claims Quality Auditor in Bloomington, IN
Evaluates claims activities of other departments and / or companies.
December 05, 2019