Quality Assurance Specialist - Medical Claims

Employer Industry: Healthcare Technology

Why consider this job opportunity...
• Salary up to $55,000
• Eligible for health, dental, vision, and mental health benefits
• Opportunity for career advancement and growth within the organization
• Supportive and diverse work environment that celebrates differences
• Chance to make a positive impact on the claims process and overall member wellbeing

What to Expect (Job Responsibilities):
• Review internal procedures and analyze claims data to identify and correct incorrectly paid claims
• Record and track quality assessment scores while providing feedback to reduce errors
• Monitor departmental performance and support the implementation of process improvements
• Assist with the development of document control related to the Quality Assurance system
• Ensure compliance with HIPAA regulations regarding the privacy and security of Protected Health Information (PHI)

What is Required (Qualifications):
• High school diploma or equivalent (GED)
• Knowledge of medical terminology, including ICD-9, CPT & HCPCS coding
• Healthcare or claims processing experience
• Proficient in Microsoft Word, Excel, and Outlook
• Strong organizational skills with the ability to manage time effectively in a fast-paced environment

How to Stand Out (Preferred Qualifications):
• Excellent written and verbal communication skills
• Ability to work independently with sound judgment
• Highly organized and detail-oriented with extreme accuracy
• Experience in quality assurance or auditing processes within healthcare

#HealthcareTechnology #QualityAssurance #ClaimsProcessing #CareerOpportunity #DiversityAndInclusion

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