Claims Quality Audit Director jobs in Phoenix, AZ

Claims Quality Audit Director directs and oversees the operations of the claims quality audit department to follow the audit policies, procedures and regulation. Provides professional knowledge and guidance on technical or procedural problems. Being a Claims Quality Audit Director creates claims audit policies and procedures. May recommend changes in claims processing procedures. Additionally, Claims Quality Audit Director typically Requires a bachelor's degree. Typically reports to top management. The Claims Quality Audit Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Claims Quality Audit Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)

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Director of Claims
  • Jewish Family & Children's Service
  • Phoenix, AZ FULL_TIME
  • Jewish Family and Children’s Service’s (JFCS) values each and every talented applicant, regardless of religious beliefs, race, age, origin, gender, sexual orientation, or cultural background. JFCS places a high value on inclusion and diversity, whether that applies to our employees or the nearly 40,000 clients receiving our services throughout the Valley.

    Director of Claims: This role directs the claims functions of JFCS and is accountable for business results through cost-effective and timely resolution of claims. In conjunction with Senior Management, the Claims Director works within assigned limits of the highest authority on assignments requiring a high degree of technical complexity and coordination.

    Duties include:
    • Utilizing revenue cycle management best practices and compliant processes, manages claims submission, payment reporting, and claims collections to contribute to organizational sustained profitability.
    • Manages the Claims Department personnel and ancillary expenditures to maintain budgetary targets and control expenses.
    • Creates policies and procedures to prevent fraud, diminish incorrect billings and assure ethical claims administration outcomes.
    • Devises training programs to engage staff in processing claims correctly avoiding excessive rebilling of claims, claims denials and aged claims.
    • Develops strategies and collaborates with senior management to reconcile claims timely, review associate documentation and prevent claims denials.
    • Maintains currency and possesses full knowledge of billing requirements for all Payers, State Agencies and Federal programs and changes of existing practices and methods and keeps the CFO/COO updated on all impactful guidelines.
    • Manages, instructs, and directs staff toward claims administration objectives that assure productivity, profitability and task efficiency.
    • Effectively coordinates with Client Eligibility to manage client/insurance coverage related claims.
    • Audits and conducts file reviews to ensure staff are compliant with insurance laws, claims and policy guidelines.
    • Directs the work of claims staff to ensure deadlines and timelines are met and designated goals and objectives achieved.
    • Ensures reconciliation of cash received to cash posted is completed on a monthly basis.
    • Manages third party claims.
    • Performs other tasks as assigned.

    Qualifications:
    • Ten years of experience in directing claims administration preferably in a non-profit or an equivalent of private/public sector experience.
    • Adeptness utilizing Next Gen, Excel and other data analytical technology.
    • Ability to speak and write with clarity.
    • Bachelor’s degree or an equivalent amount of experience and training in financial and data analytics, or behavioral claims administration.

    Benefits of Working with JFCS:
    • Bonus Programs for both full-time and part-time employees.
    • FREE Primary HealthCare to all employees and every member of their household, regardless of relationship. This includes virtual doctor's visits, physicals, lab tests, x-rays, vaccinations, prescriptions, and telehealth.
    • Generous Employee Referral Bonuses for both the new-hire and the referring employee.
    • Bilingual (Spanish-English) Pay Differential.
    • Flexible Scheduling and Telehealth Flexibility for many positions.
    • 401(k) Retirement Plan, with Company Match.
    • We offer tuition and clinical license reimbursement.
    • Numerous professional development and career growth opportunities.
    • Generous paid time off / sick time allocations.
    • Comprehensive Employee Benefits package, including medical, vision, dental, & more.
    • Wellness Coaching.
    • Employee Assistance Program.
    • Eligibility for Loan Forgiveness Programs in many positions.
  • 1 Month Ago

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Associate Audit Director
  • Western Alliance Bancorporation
  • Phoenix, AZ FULL_TIME
  • Job Title:Associate Audit DirectorLocation:CityScapeWhat you'll do:As an Associate Audit Director you will plan, oversee and report on various audits in your assigned coverage areas, supporting the ex...
  • 1 Month Ago

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Director of Corporate Internal Audit
  • Test
  • Phoenix, AZ FULL_TIME
  • ABOUT THE ROLE The Director, Corporate Internal Audit who will provide leadership to the internal audit team for timely and accurate scoping, design, and testing of internal controls in compliance wit...
  • 24 Days Ago

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AZ - Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Phoenix, AZ 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...
  • 27 Days Ago

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Deputy Assistant Director, Audit District
  • Arizona Department of Revenue
  • Phoenix, AZ FULL_TIME
  • ARIZONA DEPARTMENT OF REVENUE Funding Arizona's future through excellence in innovation, exceptional customer service and public servant-led continuous improvement.All Arizona State employees operate ...
  • 2 Days Ago

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Deputy Assistant Director, Audit District
  • State of Arizona
  • PHOENIX, AZ FULL_TIME
  • ARIZONA DEPARTMENT OF REVENUE Funding Arizona’s future through excellence in innovation, exceptional customer service and public servant-led continuous improvement.All Arizona State employees operate ...
  • 4 Days Ago

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0 Claims Quality Audit Director jobs found in Phoenix, AZ area

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Sr Construction Quality Control Manager
  • Fluor Corporation
  • Chandler, AZ
  • Job Description This position may be assigned to one of the Operation Centers or to a specific project. The Principal Jo...
  • 4/19/2024 12:00:00 AM

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Clinical Quality Control Specialist
  • Kelly Science, Engineering, Technology & Telecom
  • Phoenix, AZ
  • Clinical Product Quality Specialist Kelly Science and Clinical is hiring for a temp-to-perm need for one of our clients ...
  • 4/19/2024 12:00:00 AM

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Quality Control Inspector Level 3
  • Corbins
  • Phoenix, AZ
  • Overview At Corbins, people come first! Our teammates, partners, and customers can expect that we genuinely care to serv...
  • 4/19/2024 12:00:00 AM

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Manufacturing Engineer
  • MJS Designs, Inc.
  • Phoenix, AZ
  • Company Overview MJS Designs, Inc. has been mastering complex printed circuit board electronic engineering design and ma...
  • 4/18/2024 12:00:00 AM

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Quality Coordinator (RN) - Inpatient Rehab
  • Select Medical Corporation
  • Phoenix, AZ
  • Overview Banner Rehabilitation Hospital * A joint venture with Select Medical & Banner Hospital* Phoenix, AZ Quality Coo...
  • 4/18/2024 12:00:00 AM

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Manager Clinical Nursing
  • IASIS Healthcare
  • Phoenix, AZ
  • Manager Clinical NursingClick Here to Apply OnlineJob DescriptionLocation: St. Luke's Behavioral Health CenterPosted Dat...
  • 4/18/2024 12:00:00 AM

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Director of Quality Management
  • Select Specialty Hospital - Phoenix
  • Phoenix, AZ
  • Overview: Critical Illness Recovery Hospital Director of Quality Management $10,000 Sign-On Bonus At Select Specialty/Re...
  • 4/16/2024 12:00:00 AM

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Manufacturing Engineer
  • Mjs Designs Inc.
  • Phoenix, AZ
  • Company Overview MJS Designs, Inc. has been mastering complex printed circuit board electronic engineering design and ma...
  • 4/16/2024 12:00:00 AM

Phoenix is in the southwestern United States, in the south-central portion of Arizona; about halfway between Tucson to the southeast and Flagstaff to the north. By car, the city is approximately 150 miles (240 kilometers) north of the US-Mexico border at Sonoyta and 180 mi (290 km) north of the border at Nogales. The metropolitan area is known as the "Valley of the Sun" due to its location in the Salt River Valley. It lies at a mean elevation of 1,086 feet (331 m), in the northern reaches of the Sonoran Desert. Other than the mountains in and around the city, the topography of Phoenix is gener...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Audit Director jobs
$149,787 to $214,065
Phoenix, Arizona area prices
were up 2.2% from a year ago

Claims Quality Audit Director in Olympia, WA
Based on our compensation data, the estimated salary potential for Claims Quality Audit Director will increase 16 % over 5 years.
December 23, 2019