Healthcare Claims Quality Analyst

Job Summary

A company is looking for a Healthcare Claims Quality Analyst (QA).

Key Responsibilities

• Conduct detailed quality reviews on claim files to ensure compliance with guidelines and regulations
• Identify error trends and provide actionable feedback to claims examiners and team leaders
• Analyze root causes and recommend process improvement opportunities

Required Qualifications

• 1+ years of experience with Medicaid and commercial claims
• Experience in quality assurance (QA) or auditing of medical claims
• High school diploma or equivalent
• Knowledge of medical terminology and coding standards
• Proficient in Microsoft Office and able to navigate multiple systems