Claims Quality Audit Manager jobs in Los Angeles, CA

Claims Quality Audit Manager manages the claims quality auditors and daily activities of quality claims audit function. Reviews and tracks claims quality audit reports and measures performance of auditors. Being a Claims Quality Audit Manager provides assistance in developing claims audit policies and procedures. May provide coaching in complex claims audit. Additionally, Claims Quality Audit Manager typically requires a bachelor's degree. Typically reports to a director or head of a department. The Claims Quality Audit Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Claims Quality Audit Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Claims Manager
  • QUALITY CARE SURGERY CENTER, LLC
  • Northridge, CA FULL_TIME
  • Position Summary:

     

    Claims processing from data entry to review of all claims prior to payment. Customer service. MM Department support.

     

    Essential Duties and Responsibilities include the following:

    • Daily claims data entry/ manual adjudication
    • Daily review of claims status report
    • Claims customer service
    • Support UM department
    • Verify eligibility and benefits
    • Encounter data entry
    • Verify claims received via fax
    • Re-direct claims when necessary
    • Claim review with verification of benefits
    • Work directly with Northridge office for claims review and payment process
    • Communicate with health plan regarding claim appeals
    • Meet with Medical Director for claims review
    • Review final claim payment EOB’s , copying and mailing
    • Assist Executives with special projects
    • Know location of Policy and Procedure and communication books and be familiar with contents
    • All other duties as directed by management

    The pay range for this position at commencement of employment is expected to be between  $90,000 - $95,000 annually; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

     

    The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

     

    Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

     

    If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

     

    As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

     

    Full Time Position Benefits:

     

    The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

     

    Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

     

    Health and Wellness:

    • Employer-paid comprehensive medical, pharmacy, and dental for employees
    • Vision insurance
    • Zero co-payments for employed physician office visits
    • Flexible Spending Account (FSA)
    • Employer-Paid Life Insurance
    • Employee Assistance Program (EAP)
    • Behavioral Health Services

    Savings and Retirement:

    • 401k Retirement Savings Plan
    • Income Protection Insurance

    Other Benefits:

    • Vacation Time
    • Company celebrations
    • Employee Assistance Program
    • Employee Referral Bonus
    • Tuition Reimbursement
    • License Renewal CEU Cost Reimbursement Program
    • Business-casual working environment
    • Sick days
    • Paid holidays
    • Mileage

    Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

  • 2 Days Ago

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Quality Control Manager
  • Lusk Quality
  • Palmdale, CA FULL_TIME
  • RESPONSIBILITIES Responsible for maintaining ISO System (QS) – includes review, Audits, training, updates, revisions. Manage reported red tags daily – Inspector and Machinist initiated – detail, revie...
  • 20 Days Ago

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Claims Appeal Auditor
  • QUALITY CARE SURGERY CENTER, LLC
  • Northridge, CA FULL_TIME
  • Essential Duties and Responsibilities include the following: 1.Maintain the workflow of all departmental projects. 2.Ensure priority sorting, batching & logging by provider and provider type for all c...
  • 10 Days Ago

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Audit Manager and Audit Seniors
  • Gables Search Group
  • Woodland, CA FULL_TIME
  • CPA Firm Audit Managers and Seniors - Hybrid living close to the office is preferred - Fully Remote Home Based is available for candidates living in the PST or MST time zones. Will assist with relocat...
  • 14 Days Ago

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Audit Manager and Audit Seniors
  • Impact Solutions Inc
  • Los Angeles, CA FULL_TIME
  • CPA Firm Audit Managers and Seniors - Hybrid living close to the office is preferred - Fully Remote Home Based is available for candidates living in the PST or MST time zones. Will assist with relocat...
  • 16 Days Ago

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Audit Manager and Audit Seniors
  • Food Management Search
  • Los Angeles, CA FULL_TIME
  • CPA Firm Audit Managers and Seniors - Hybrid living close to the office is preferred - Fully Remote Home Based is available for candidates living in the PST or MST time zones. Will assist with relocat...
  • 27 Days Ago

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0 Claims Quality Audit Manager jobs found in Los Angeles, CA area

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Sr. Quality Control Technician - Biochemistry
  • Takeda Pharmaceutical
  • Los Angeles, CA
  • By clicking the Apply button, I understand that my employment application process with Takeda will commence and that the...
  • 3/28/2024 12:00:00 AM

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Senior Process Engineer
  • Takeda Pharmaceutical
  • Los Angeles, CA
  • By clicking the Apply button, I understand that my employment application process with Takeda will commence and that the...
  • 3/28/2024 12:00:00 AM

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Assistant Manager, Quality Performance
  • Goat
  • Los Angeles, CA
  • ???? **Privacy Notice** **Assistant Manager, Quality Performance** Los Angeles, CA / GOAT Consumer Experience / Full-tim...
  • 3/28/2024 12:00:00 AM

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Production Supervisor at New Venture
  • SoLa Impact
  • Los Angeles, CA
  • JOB SUMMARY As a Production Supervisor, you will be responsible for overseeing the day-to-day operations of our modular ...
  • 3/27/2024 12:00:00 AM

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Photo & Post Production Associate
  • VICI
  • Los Angeles, CA
  • VICI is the ultimate shopping destination for the modern fashionista. Our assortment covers women's apparel, accessories...
  • 3/27/2024 12:00:00 AM

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Food Safety Manager
  • Erewhon
  • Los Angeles, CA
  • Join the movement! Erewhon market is trailblazing in the health and wellness industry, and we're rapidly expanding! Our ...
  • 3/27/2024 12:00:00 AM

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Quality Assurance Intern GOAT Product Management and Entrepreneurship | Start Date: 07/19/2021 Hosted by UNITE-LA
  • Guided Compass
  • Los Angeles, CA
  • **Quality Assurance Intern @ GOAT** Description The Quality Assurance team is responsible for testing to ensure the qual...
  • 3/27/2024 12:00:00 AM

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Director, Production
  • Wasserman
  • Los Angeles, CA
  • Wasserman powers the business of sports, music, entertainment and culture. We serve clients with exceptional insight, in...
  • 3/26/2024 12:00:00 AM

Los Angeles (/lɔːs ˈændʒələs/ (listen);[a] Spanish: Los Ángeles), officially the City of Los Angeles and often known by its initials L.A., is the most populous city in California, the second most populous city in the United States, after New York City, and the third most populous city in North America. With an estimated population of four million, Los Angeles is the cultural, financial, and commercial center of Southern California. The city is known for its Mediterranean climate, ethnic diversity, Hollywood and the entertainment industry, and its sprawling metropolis. Los Angeles is the larges...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Audit Manager jobs
$108,236 to $145,413
Los Angeles, California area prices
were up 3.2% from a year ago

Claims Quality Audit Manager in Canton, OH
On average, a Bachelor's Degree is the highest level of education for a Claims Quality Audit Manager.
January 04, 2020
Claims Quality Audit Manager in Kennewick, WA
Based on our compensation data, the estimated salary potential for Claims Quality Audit Manager will increase 16 % over 5 years.
January 17, 2020