New York Claims Quality Analyst

Job Summary

A company is looking for a Claims Quality Analyst.

Key Responsibilities

• Conducts quality audits by reviewing medical reports for completeness and accuracy
• Communicates with clients and reviewers to address questions and provide updates on referral progress
• Ensures reports meet quality assurance standards and are formatted correctly for approval

Required Qualifications

• Preferred Associate's Degree or Bachelor's Degree
• Business experience in a healthcare and/or insurance setting
• Experience in NY Workers Compensation is preferred
• Operations experience with Peer Review, UR, and/or case management
• Familiarity with technology-based processes in a business environment