Claims Quality Auditor jobs in South Dakota
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
Auditor
- CGS Federal (Contact Government Services)
-
Pierre, SD
FULL_TIME
-
Employment Type: Full-Time, Mid-Level
Department: Financial
CGS is seeking a highly skilled Auditor to provide general auditing and accounting services in support of fraud investigations involving potentially complex financial transactions and complex organizations attempting to evade detection. The ideal candidate will develop, coordinate, and draft technical audit guidelines, is proficient in a variety of accounting systems, and practices excellent cross-functional communication throughout investigations.
CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities.
Skills and attributes for success:- Analyze and audit a variety of accounting systems
- Analyze, organize, and present a large volume of data such as bank records, financial records, healthcare claims, tax records, correspondence, policies, other documentary evidence, etc., through the use of common software programs
- Assist with the planning of investigations, including performing quantitative and qualitative analyses to identify potential witnesses and relevant financial documents
- Prepare concise and accurate reports of results of analysis, including detailed charts, summaries and schedules as necessary
- Assist with conferences and interviews of representatives of financial institutions, Certified Public Accountants, and other potential witnesses to financial activities
- Utilize electronic databases to identify assets, documents, and other physical evidence
- Analyze an individual or corporation’s ability to pay monetary penalties based on financial disclosures and independent investigation of assets and liabilities
- Perform ancillary investigation-related services in support of assigned cases as follows:
- Develop, coordinate and issue draft technical audit guidelines and instructions applicable to financial audits and investigations
- Prepare interim and final reports throughout the investigation process for use by staff members
- Arrange for secure storage, preservation, organization and indexing of voluminous documentary evidence
- Assist in the compilation and analysis of documents and physical evidence, and the creation of charts, graphs, and other audio-visual materials for use in motions and at trial
- Meet with the designated federal agency personnel, state and local officials as needed throughout investigations
- Other related duties as assigned and within scope.x
- Four-year undergraduate degree or higher in statistical/data analysis, finance, accounting, fraud examination, or other related field
- Minimum 3 years of professional work experience in finance, accounting, fraud examination or statistical/data analysis
- Proficient in Microsoft Office applications including Word, Excel, PowerPoint, Access, etc
- U.S. Citizenship and ability to obtain adjudication for the requisite background investigation
- Experience and expertise in performing the requisite services in Section 3 Preferred qualifications:
- Experience reviewing and understanding medical records and knowledge of medical billing procedures, including experience using STARS and/or Business Objects
- Relevant experience working with a federal or state legal or law enforcement entity
Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client’s specific needs. We are committed to solving the most challenging and dynamic problems.
For the past seven years, we’ve been growing our government-contracting portfolio, and along the way, we’ve created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work.
Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come.
We care about our employees. Therefore, we offer a comprehensive benefits package.- Health, Dental, and Vision
- Life Insurance
- 401k
- Flexible Spending Account (Health, Dependent Care, and Commuter)
- Paid Time Off and Observance of State/Federal Holidays
Join our team and become part of government innovation!
Explore additional job opportunities with CGS on our Job Board:
https://cgsfederal.com/join-our-team/
For more information about CGS please visit: https://www.cgsfederal.com or contact:
Email: info@cgsfederal.com - 9 Days Ago
Shipping and Receiving Clerk
- Quality Tool
-
Brookings, SD
FULL_TIME
- Potential to Earn A $2,500 Hiring Bonus!! Job Description: Quality Tool, Inc. is a precision metal fabricator and machining manufacturer seeking a reliable, motivated and team-minded Shipping Clerk to...
- 28 Days Ago
Maintenance Supervisor/Technician
- Quality Tool
-
Brookings, SD
FULL_TIME
- *Hiring Bonus Available - Up to $2500! Maintenance Supervisor/Technician Quality Tool is an ISO9001:2015 certified contract manufacturer that delivers metal components to Fortune 500 companies. Qualit...
- 18 Days Ago
RN PCU Rapid City, SD
- Quality Clinicians
-
Rapid, SD
FULL_TIME
- We are travelers building the kind of agency we always wanted, while we still work assignments. Pay Package: Weekly Pay Range: $2189.02-$3167.93/week Multiple shift openings Job Description/Responsibi...
- 20 Days Ago
Tech / Assist EMT / ER Technician Rapid City, SD
- Quality Clinicians
-
Rapid, SD
FULL_TIME
- We are travelers building the kind of agency we always wanted, while we still work assignments. Pay Package: Weekly Pay Range: $913.52/week Multiple shift openings Job Description/Responsibilities: Yo...
- 22 Days Ago
Tech / Assist Cardiac Cath Lab Rapid City, SD
- Quality Clinicians
-
Rapid, SD
FULL_TIME
- We are travelers building the kind of agency we always wanted, while we still work assignments. Pay Package: Weekly Pay Range: $1878.02-$2878.02/week Multiple shift openings Job Description/Responsibi...
- 22 Days Ago
Claims Quality Auditor jobs at Popular Companies
Quality Auditor
- Amsted Automotive Group
-
Sterling Heights, MI
- ABOUT THE ROLE Means TransForm Products is now the newest business unit of the Amsted Automotive Group, a premier techno...
- 6/2/2024 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...
- 6/1/2024 12:00:00 AM
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...
- 5/31/2024 12:00:00 AM
Claims Quality Auditor
- UCLA Health
-
Los Angeles, CA
- General Information Press space or enter keys to toggle section visibility Work Location: Los Angeles, USA Onsite or Rem...
- 5/31/2024 12:00:00 AM
Quality Auditor
- Johnson Controls
-
Wichita, KS
- What you will do: Performs Quality Audits on finished goods (box audits), purchased parts, in process part and subassemb...
- 5/31/2024 12:00:00 AM
Quality Auditor
- International Automotive Components
-
Anniston, AL
- Summary: Working under the direction of the Manufacturing Supervisor/Team Leader, performs various product and process a...
- 5/30/2024 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...
- 5/29/2024 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 South Dakota
South Dakota (/- dəˈkoʊtə/ (listen)) is a U.S. state in the Midwestern region of the United States. It is named after the Lakota and Dakota Sioux Native American tribes, who compose a large portion of the population and historically dominated the territory. South Dakota is the seventeenth largest by area, but the fifth smallest by population and the 5th least densely populated of the 50 United States. As the southern part of the former Dakota Territory, South Dakota became a state on November 2, 1889, simultaneously with North Dakota. Pierre is the state capital and Sioux Falls, with a populat...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$41,446 to $50,800
Most Popular Cities in South Dakota 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