Direct: Ext: 203
Job Description
Quality Lead
Location: Scottsdale, AZ
Duration: till end-Sep with very high probability of extensions.
Please see the JD for the Quality Team Lead below.
Responsibilities
- Assist the Quality Supervisor in managing a team of contingent resources.
- Manage the performance of contingent staff.
- Monitor the production and quality of processed claims to ensure all CMS and Contractual standards are met.
- Manage inventory by assigning work and setting up daily goals for quality coordinators.
- Help the supervisor create error reports and Pareto charts and work with the processing team to provide coaching feedback.
- Track individual performance based on claims reviewed and errors missed for contingent resources.
- Provide feedback to contingent staff.
- Resolve daily impediments to ensure flawless execution of the quality control process.
- Allocate 25% of time to perform actual quality control execution work for high‑risk clients.
- Oversee any department issues and work with internal partners to track resolution of any challenges.
Required Qualifications
- 3+ years of experience in the health care industry.
- 1+ year of experience in quality control and claims audit.
- 1+ year of supervisory experience.
- 1+ year of experience working with Excel, Word, and PowerPoint.
- 1+ year in a role requiring an understanding of Human Resource policies.
Preferred Qualifications
- 1+ year of previous experience in pharmacy and/or medical claims processing.
- Experience with MedD regulations.
- Ability to run a high volume production team with an emphasis on quality output.
- Excellent verbal and written communication skills.
- Ability to interact with internal partners and clients in a professional manner.
- Ability to make sound operational decisions in a fast‑paced, high‑stress environment.
Additional Information
All your information will be kept confidential according to EEO guidelines.
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