Top 6188 Quality data auditor Jobs

Claims Quality Auditor - Remote
ImagenetLLC —Remote
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Analysis skills
- Paid training
- Health savings account
13d
Quality Improvement & Data Coordinator
The Collaborative for Children and Families —Remote
- $55,000 - $60,000 a year
- Weekends as needed
- Remote
- Basic math
- Mid-level
- Residential
- Health insurance
- Dental insurance
Quick Apply
10d
Lead Quality Auditor
Expo Home Improvement —Remote
- Part-time
- Remote
- Google Workspace
- Mid-level
- Residential
APQP Quality Engineer
Crane Aerospace & Electronics —Elyria, OH
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Paid holidays
- Health insurance
Coding and Compliance Auditor
South Shore Health —Weymouth, MA
- $73,000 - $104,400 a year
- Full-time
- Hybrid work
- 5 years
- Mid-level
- Acute care experience
Insurance Premium Auditor-Workers' Compensation
SFM Mutual Insurance Company —Bloomington, MN
- $28.70 - $40.18 an hour
- Full-time
- Hybrid work
- Ability to walk for extended periods
- Word processing
- Mid-level
- Paid parental leave
- Health savings account
Senior Accountant
Magnus Capital Partners —Grand Rapids, MI
- Up to $75,000 a year
- Full-time
- Background check
- CPA
- 5 years
- Disability insurance
- Health insurance
Quick Apply
Laboratory Manager
National Beef —Dodge City, KS
- Full-time
- 18 years or older
- Computer literacy
- Mid-level
- Disability insurance
- Health insurance
Supplier Quality Engineer
Nifco America, Corp. —Canal Winchester, OH
- $70,000 - $88,000 a year
- Full-time
- Up to 50% travel
- Mid-level
- Microsoft Office
- Relocation assistance
- Health insurance
Quick Apply
Quality Auditor
Maysteel Industries LLC —Frederick, CO
- $21 - $25 an hour
- Full-time
- High school diploma or GED
- US work authorization
- Cleaning
- Health savings account
- Health insurance
Quick Apply
12d
Lead EHS Coordinator
INNIO —Waukesha, WI
- In-person
- Senior level
- Associate's degree
Quick Apply
Production Quality Engineer
Nifco America, Corp. —Canal Winchester, OH
- $65,000 - $80,000 a year
- Full-time
- Background check
- Microsoft Excel
- Writing skills
- Health savings account
- Relocation assistance
Quick Apply
Plant Controller
Bel Group —Brookings, SD
- Full-time
- Oracle
- 5 years
- Office
Controller
Techmark, Inc. —Lansing, MI
- $90,000 - $107,000 a year
- Full-time
- CPA
- Customer service
- Writing skills
- Health savings account
- Disability insurance
Quick Apply
Financial Controller
Oak Hill Contractors, LLC —Ewing, IL
- $75,000 - $100,000 a year
- Extended hours
- Management
- CPA
- Construction site
- Health insurance
- Dental insurance
Quick Apply
Underwriter/Senior Underwriter
CIS Trust —Wilsonville, OR
- $100,092 - $137,311 a year
- Online Application
- Hybrid work
- Background check
- 5 years
- Public speaking
- Health insurance
- Dental insurance
3d
Food Safety Compliance Lead
The Hershey Company —Bluffton, IN
- Online Application
- 5 years
- Bachelor of Science
- Master's degree
Experienced Director of Finance and Development for Catholic Cathedral & Parishes
Portland Peninsula and Island Parishes —Portland, ME
- $65,000 - $80,000 a year
- Full-time
- Background check
- CPA
- 5 years
- Health insurance
- Dental insurance
Quick Apply
6d
Coder Auditor/Senior CDI Specialist
HAMASPIK CHOICE INC —Spring Valley, NY
- $83,000 - $90,000 a year
- Full-time
- Writing skills
- Mid-level
Quick Apply
Director of Accounting
HealthPoint —Renton, WA
- $137,370 - $234,900 a year
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- CPA
- Wellness program
- Health savings account
Quick Apply

I want to receive the latest job alert for quality data auditor

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Claims Quality Auditor - Remote

ImagenetLLC -
Remote

Apply Now

Job Details

Full-time
13 days ago

Benefits

Paid training
Health savings account
Paid holidays
Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

High school diploma or GED
Health insurance knowledge
Medicaid regulations

Full Job Description

Claims Quality Auditor| Remote

Job Type: Full time

Work Setup: Remote

Reports to: Claims Supervisor

Position Summary:

The Claims Quality Auditor plays a key role in ensuring the accuracy, compliance, and effectiveness of claims processing and provider dispute resolution. The ideal candidate has hands on experience with EZCap, auditing claims, analyzing dispute claims and evaluating internal policies and regulatory requirements, with a particular focus on Medi-Cal and commercial health plans. This role is responsible to partners closely with cross-functional teams to drive continuous improvement and operational excellence.

Key Duties:

Perform detailed audits of denied, underpaid, and processed claims using EZCap to assess accuracy and compliance with provider contracts and regulatory guidelines.
Analyze provider disputes for patterns or recurring issues.
Identify root causes and work with relevant teams to implement corrective actions and process improvements.
Develop and track performance related to claims accuracy, turnaround time, and dispute resolution efficiency.
Conduct thorough root cause analyses on high-impact errors or escalations.
Support training initiatives by identifying knowledge gaps and assisting in the development of updated procedures and documentation based on audit results.
Ensure all reviewed processes align with applicable regulatory requirements. Participate in internal and external audits as needed.

Qualifications:

High school diploma or equivalent
At least 3-5 years of Quality Analyst in healthcare, TPA, or health plan settings/ healthcare claims or in a claims processing/adjudication environment
Hands-on experience with EZCap (strongly preferred)
Familiarity with Medi-Cal and Commercial insurance claim
Strong analytical and problem-solving skills
Excellent verbal and written communication
Attention to detail in documentation and compliance
Ability to manage multiple tasks and meet deadlines
Experience with other claim adjudication platforms and provider systems.
Familiarity with DHCS, DMHC, CMS dispute handling regulations.

What We Offer

Remote work offered
Equipment provided
Paid training to set you up for success
Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
Paid Time Off (PTO)
7 paid holidays
A supportive team and a company that values internal growth

COMPANY OVERVIEW:

Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.

Work Location: Remote

Apply Now

Refine Your Search

quality data auditor jobs

Claims Quality Auditor - Remote

Quality Improvement & Data Coordinator

Lead Quality Auditor

APQP Quality Engineer

Coding and Compliance Auditor

Insurance Premium Auditor-Workers' Compensation

Senior Accountant

Laboratory Manager

Supplier Quality Engineer

Quality Auditor

Lead EHS Coordinator

Production Quality Engineer

Plant Controller

Controller

Financial Controller

Underwriter/Senior Underwriter

Food Safety Compliance Lead

Experienced Director of Finance and Development for Catholic Cathedral & Parishes

Coder Auditor/Senior CDI Specialist

Director of Accounting

I want to receive the latest job alert for quality data auditor

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected