Quality Assurance Specialist

Job Summary

To support client success initiatives, the full-time remote Quality Assurance Specialist III will perform quality assurance reviews of complex overpayment accounts, serve as a subject matter expert on quality standards, and identify operational risks while facilitating team member onboarding and new client implementations.

Key responsibilities

• Apply advanced knowledge of payer requirements and quality assurance methodologies to review complex overpayment cases
• Evaluate root cause determinations and ensure adherence to quality standards and client requirements
• Identify quality trends and recommend process improvements to enhance efficiency and consistency

Required qualifications

• Bachelor's degree in business, healthcare, or a related field, or equivalent experience in the healthcare field
• Solid knowledge of overpayment recovery services
• Strong analytical skills
• Ability to learn quickly and provide value-added service
• Experience working under tight deadlines