Claims Quality Auditor jobs in Fresno, CA

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)

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Claims Associate - Workers' Comp
  • Pacific Claims Management
  • Fresno, CA FULL_TIME
  • The Claims Associate position provides support to workers’ compensation claims adjusters and other claims staff.

    Experience

    Ideally this candidate will have experience with workers' compensation in a claims or legal setting and will be bilingual Spanish/English.

    Work hours are Monday through Thursday 8:00-5:00, with the opportunity to leave at 1:00 on most Fridays.

    Responsibilities include:

    • Entering and reviewing notes/diaries in claims management system as instructed.
    • Entering all types of indemnity payments
    • Composing and issuing benefit notices
    • Contacting claimants and employers to obtain necessary information or documentation; complete required forms; and prepare correspondence.
    • Obtaining work status information from treating physicians
    • Scheduling medical appointments and issuing appointment notices and mileage payments

    Skill and Knowledge Requirements

    • Excellent oral and written communication skills
    • PC literate, including Microsoft Office products
    • Strong organizational skills
    • Ability to work in a team environment
    • Business arithmetic

    Ability to:

    • Learn laws and procedures associated with workers' compensation and learn to make routine decisions on simple cases, based on instructions and a defined set of guidelines.
    • Learn to understand, explain, and apply workers' compensation principles, techniques and procedures to answer verbal and written communications and inquiries
    • Communicate clearly and concisely both orally and in writing
    • Establish and maintain effective working relationships with those contacted in the course of work
    • Verify the accuracy of, and maintain confidential information

    Job Type: Full-time

    Pay: $21.00 - $24.00 per hour

    Benefits:

    • 401(k) matching
    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Professional development assistance
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Work setting:

    • In-person
    • Office

    Work Location: In person

  • 28 Days Ago

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CA - Field Representative
  • Hancock Claims Consultants
  • Fresno, CA FULL_TIME
  • With a 20-year history supporting property insurers, Hancock Claims Consultants provides a nationwide network of inspectors, contractors, and engineers who help adjusters quickly process claims. All 5...
  • 17 Days Ago

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Contents Field Inspector(Open Link in new window)
  • TheBest Claims Solutions
  • Fresno, CA FULL_TIME
  • As a Contents Field Inspector, you will assist customers who have experienced hardship by compiling a detailed list of items that have been lost or damaged. This is an on-call, temporary assignment th...
  • 28 Days Ago

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Claims Examiner
  • TEKsystems
  • Fresno, CA FULL_TIME
  • A large medical group in Fresno is looking to add on expereinced claims processing reps to join the team onsite!Highlights:Location: Onsite in FresnoPay: $19Schedule:M-FLow turnover deparment and lots...
  • 15 Days Ago

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Claims Specialist
  • TEKsystems
  • Fresno, CA FULL_TIME
  • Description:Maintain multiple groups2. Process CMS-1500 claims3. Process UB-04 claims4. Process high dollar claims5. Process JAA / BlueCard claims6. Interpret individual group SPD’s and apply benefits...
  • 1 Month Ago

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Claims Coordinator
  • Oppy
  • Visalia, CA FULL_TIME
  • About Oppy Grow our tomorrow. Celebrating over 160 years in business, we are one of North America's top fresh produce sales and marketing companies. We bring over 100 varieties of produce from more th...
  • 25 Days Ago

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0 Claims Quality Auditor jobs found in Fresno, CA area

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Retail Operations Manager
  • Hudson Group
  • Fresno, CA
  • Grow With Us! Hudson is North America's leading travel retailer. For over 30 years, Hudson has met the needs and wants o...
  • 4/24/2024 12:00:00 AM

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Assurance Manager - Financial Services
  • Moss Adams Llp
  • Fresno, CA
  • Job Description - Assurance Manager - Financial Services (26551)Assurance Manager - Financial Services ( Job Number: 265...
  • 4/24/2024 12:00:00 AM

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Manager of Research and Development
  • Pacific Choice Brands Inc.
  • Fresno, CA
  • Job Summary: Candidate must have a solid understanding of Fresh/Shelf Stable Salsas, Sauces or other similar products. A...
  • 4/23/2024 12:00:00 AM

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Assurance Manager - Real Estate
  • Moss Adams Llp
  • Fresno, CA
  • Job Number: Assurance Manager - Real Estate ( Job Number: 26545 )Employee Status Employee Status : Regular Schedule : Fu...
  • 4/23/2024 12:00:00 AM

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Quality Manager
  • E. & J. Gallo
  • Fresno, CA
  • E. & J. Gallo Winery Privacy Policy Why Gallo? With a global portfolio of over 100 unique wine and spirits brands, we ar...
  • 4/22/2024 12:00:00 AM

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QA Lead
  • The Wonderful Company
  • Del Rey, CA
  • Company Description From tree to table, POM Wonderful delivers a whole lot of healthy. Known for our iconic double-bubbl...
  • 4/22/2024 12:00:00 AM

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SECURITY AGENT FT
  • Springboard Hospitality
  • Fresno, CA
  • Job Details Job Location Piccadilly Inn - Fresno, CA Description About our company: Springboard Hospitality is a premier...
  • 4/22/2024 12:00:00 AM

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Plant Manager
  • Altium Packaging LLC
  • Fresno, CA
  • Location Address: 2875 S Elm Ave,, Fresno, California 93706 Work Shift: Salary Exempt (United States of America) Altium ...
  • 4/21/2024 12:00:00 AM

Fresno (/ˈfrɛznoʊ/ FREZ-noh; Spanish for "ash tree") is a city in California, United States, and the county seat of Fresno County. It covers about 112 square miles (290 km2) in the center of the San Joaquin Valley, the southern portion of California's Central Valley. Named for the abundant ash trees lining the San Joaquin River, Fresno was founded in 1872 as a railway station of the Central Pacific Railroad before it was incorporated in 1885. The city has since become an economic hub of Fresno County and the San Joaquin Valley, with much of the surrounding areas in the Metropolitan Fresno regi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$46,071 to $56,468
Fresno, California area prices
were up 2.7% from a year ago

Claims Quality Auditor in Bloomington, IN
Evaluates claims activities of other departments and / or companies.
December 05, 2019