Claims Quality Analyst

Job Summary

A company is looking for a Claims Quality Control Analyst.

Key Responsibilities:

• Analyze, investigate and approve high dollar claims for payment
• Support leadership in scoping, sizing, prioritizing items, and delivering solutions
• Identifying root cause of claims issues, collaborating cross-functionally to resolve and avoid future similar issues

Required Qualifications:

• 2+ years of experience in claims processing, auditing, and health plan operations
• 1+ years experience in project work within claims operations
• 2+ years of experience working with large data sets using Excel or a database language