Quality Assurance Analyst

Job Summary

Supporting quality assurance and compliance efforts, the full-time remote Quality Assurance Analyst will conduct internal audits, enhance auditing systems, and coordinate external audit activities while collaborating with cross-functional teams.

Key Responsibilities

• Support the development and enhancement of the internal auditing platform by identifying system improvements and optimizing audit workflows
• Conduct comprehensive audits of claim examiners to evaluate adherence to policies and identify areas for improvement
• Serve as a liaison between clients, third-party vendors, and internal stakeholders to ensure efficient execution of external audits

Required Qualifications

• 10+ years of experience in claims, insurance, quality assurance, and client-facing roles, preferably in a TPA environment
• Bachelor's degree preferred; equivalent professional experience will be considered
• Advanced proficiency in Microsoft Office Suite (Excel, Word, Outlook, PowerPoint)
• Demonstrated experience with internal, client, and regulatory audits
• Working knowledge of licensing requirements and Medicare compliance