Talent.com
Medicare Quality Auditor

Medicare Quality Auditor

VirtualVocationsBoulder, Colorado, United States
3 days ago
Job type
  • Full-time
Job description

A company is looking for a Quality Auditor.

Key Responsibilities

Audit outbound calls for compliance with CMS regulations, HIPAA, and internal quality standards

Evaluate agent performance and provide feedback to supervisors for performance improvement

Maintain documentation of audit findings and support organizational readiness for audits

Required Qualifications

3 - 5 years of experience in call center quality assurance, preferably in Medicare Advantage or healthcare

Associate or bachelor's degree in healthcare, business, or related field preferred

Strong knowledge of CMS guidelines and HIPAA regulations

Experience with call recording and QA platforms

Intermediate proficiency in Word and advanced proficiency in MS Excel

Create a job alert for this search

Quality Auditor • Boulder, Colorado, United States

Related jobs
  • Promoted
Pharmacy and Quality Performance Analyst - Denver Health Medical Plan (Must Be A Colorado Resident)

Pharmacy and Quality Performance Analyst - Denver Health Medical Plan (Must Be A Colorado Resident)

Denver HealthDenver, CO, United States
Full-time
We are recruiting for a motivated Pharmacy and Quality Performance Analyst - Denver Health Medical Plan (Must Be A Colorado Resident) to join our team!. We are here for life's journey.Where is your ...Show moreLast updated: 17 days ago
  • Promoted
Senior Quality Auditor

Senior Quality Auditor

VirtualVocationsLittleton, Colorado, United States
Full-time
A company is looking for a Senior Quality Auditor.Key Responsibilities Perform audits of transactions processed by health plan administration associates Serve as an escalation resource for assoc...Show moreLast updated: 30+ days ago
  • Promoted
RN Medical Review Appeals Auditor

RN Medical Review Appeals Auditor

VirtualVocationsLakewood, Colorado, United States
Full-time
A company is looking for a Medical Review Clinical Appeals Auditor (RN) with a DME focus.Key Responsibilities Conducts clinical reviews and Appeals reviews on medical records and audit findings ...Show moreLast updated: 3 days ago
  • Promoted
Maryland Licensed Medical Director

Maryland Licensed Medical Director

VirtualVocationsBoulder, Colorado, United States
Full-time
A company is looking for a Health Plan Medical Director Physician.Key Responsibilities Participate in the development and execution of case management, disease management, and population health m...Show moreLast updated: 2 days ago
  • Promoted
Inpatient Audit Specialist

Inpatient Audit Specialist

VirtualVocationsDenver, Colorado, United States
Full-time
A company is looking for an Inpatient Audit Specialist to perform coding audits and provide education related to coding quality and compliance. Key Responsibilities Perform inpatient facility codi...Show moreLast updated: 30+ days ago
  • Promoted
Risk Adjustment Analyst - Denver Health Medical Plan ( •Must Be A Colorado Resident)

Risk Adjustment Analyst - Denver Health Medical Plan ( •Must Be A Colorado Resident)

Denver HealthDenver, CO, United States
Full-time
We are recruiting for a motivated Risk Adjustment Analyst - Denver Health Medical Plan ( •Must Be A Colorado Resident) to join our team!. We are here for life's journey.Where is your life journey tak...Show moreLast updated: 24 days ago
  • Promoted
Oncology Medical Director

Oncology Medical Director

VirtualVocationsArvada, Colorado, United States
Full-time
A company is looking for a Medical Director, Oncology & Specialty Patient Safety.Key Responsibilities Lead Product Safety Teams and ensure safety monitoring throughout the product lifecycle Over...Show moreLast updated: 30+ days ago
  • Promoted
Wisconsin Licensed Reimbursement Auditor

Wisconsin Licensed Reimbursement Auditor

VirtualVocationsLittleton, Colorado, United States
Full-time
A company is looking for a Reimbursement Auditing Specialist (Remote in Wisconsin).Key Responsibilities Assist in coding for various healthcare services including clinic, inpatient, and outpatien...Show moreLast updated: 4 days ago
  • Promoted
Certified Medical Coder

Certified Medical Coder

VirtualVocationsArvada, Colorado, United States
Temporary
A company is looking for a Certified Medical Coder on a short-term contract basis.Key Responsibilities Review and verify the accuracy of medical codes (CPT, ICD-10, EMT) assigned by the internal ...Show moreLast updated: 30+ days ago
  • Promoted
ACA / Medicare Risk Adjustment Analyst Sr.

ACA / Medicare Risk Adjustment Analyst Sr.

Baylor Scott & White HealthDenver, CO, United States
Full-time
The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes complex encounter inbound / outbound process issues, ...Show moreLast updated: 1 day ago
  • Promoted
Medical Director Opening in Colorado Springs

Medical Director Opening in Colorado Springs

US PhysiatryNone, CO, United States
Full-time
Medical Director Opening in Colorado Springs.Inpatient Rehab + Acute Care Consults .Our practice support includes : Having your own "private practice" within a group. There is no buy-in so you are tr...Show moreLast updated: 30+ days ago
  • Promoted
Certified Revenue Integrity Auditor

Certified Revenue Integrity Auditor

VirtualVocationsDenver, Colorado, United States
Full-time
A company is looking for a Remote Revenue Integrity Auditor.Key Responsibilities Perform detailed audits of medical records to ensure accuracy and compliance with billing regulations Oversee pre...Show moreLast updated: 2 days ago
  • Promoted
RN Clinical Auditor

RN Clinical Auditor

VirtualVocationsBoulder, Colorado, United States
Full-time
A company is looking for an RN Clinical Auditor.Key Responsibilities Perform clinical audit reviews for government and commercial payers to ensure compliance and quality standards Analyze medica...Show moreLast updated: 2 days ago
  • Promoted
State Licensed Clinical Quality Manager

State Licensed Clinical Quality Manager

VirtualVocationsLakewood, Colorado, United States
Full-time
A company is looking for a Clinical Quality Manager - Population Health.Key Responsibilities Leads system-wide population health projects and initiatives, developing implementation plans and oper...Show moreLast updated: 3 days ago
  • Promoted
Global Quality Assurance Associate

Global Quality Assurance Associate

VirtualVocationsBoulder, Colorado, United States
Full-time
A company is looking for a Global Project Quality Senior Associate to focus on Quality Assurance for Global Projects.Key Responsibilities Collaborate with the Global Project QA Manager on sourcin...Show moreLast updated: 3 days ago
  • Promoted
Ohio Licensed Clinical Documentation Director

Ohio Licensed Clinical Documentation Director

VirtualVocationsLakewood, Colorado, United States
Full-time
A company is looking for an Associate Director, Clinical Documentation Integrity.Key Responsibilities Oversee the Clinical Documentation Improvement (CDI) program and manage the CDI team Provide...Show moreLast updated: 2 days ago
  • Promoted
Certified Inpatient Coder

Certified Inpatient Coder

VirtualVocationsBoulder, Colorado, United States
Permanent
A company is looking for a Revenue Cycle Coder.Key Responsibilities Utilizes encoder software to assign appropriate ICD-CM diagnosis and procedure codes, MS-DRGs, APR DRGs, and other indicators ...Show moreLast updated: 30+ days ago
  • Promoted
Auditor, Quality Assurance (Aviation)

Auditor, Quality Assurance (Aviation)

Frontier Group HoldingsDenver, CO, US
Full-time
Auditor, Quality Assurance (Aviation).At Frontier, we believe the skies should be for everyone.We deliver on this promise through our commitment to Low Fares Done Right. This is more than our taglin...Show moreLast updated: 30+ days ago