Working remotely in a full-time salaried capacity, the Claims Quality Assurance Analyst will conduct quality reviews of claims processes, provide feedback for process improvement, and support the onboarding of new employees. Key responsibilities Conduct weekly audits of claims and enrollment specialists' work to ensure accuracy and adherence to procedures Prepare and maintain detailed audit findings, providing timely feedback and recommendations for process improvements Collaborate with internal departments to identify procedural gaps and monitor resolution of system deficiencies affecting quality audits Required qualifications High School Diploma or GED with at least 5 years of experience in healthcare claim processing, or an Associate Degree with 2 years of post-degree experience Proficiency in Microsoft Word, Excel, Outlook, and SharePoint Knowledge of claims adjudication processes, provider contracting, and member eligibility Experience with Medicaid, Medicare, and other third-party payment sources Strong understanding of healthcare data analysis and the health insurance industry
Claims Quality Assurance Analyst in workfromhome at Unknown Company
This position is listed as contract and able to be worked remotely.