Quality Assurance Specialist

Job Summary

A company is looking for a Quality Assurance Specialist - Non Contracted Provider Appeals.

Key Responsibilities

• Monitor and evaluate provider appeal processing activities for accuracy and compliance
• Audit appeal determinations and validate the accuracy of provider response letters
• Assist in developing training tools and participate in quality assurance reporting

Required Qualifications

• Minimum of two years of related customer service or telemarketing experience
• High School Diploma or GED required
• Preferred experience in the Medicare Managed Care industry
• Ability to type 40+ words per minute
• No specific licensure required