Quality Assurance Specialist

Job Summary

Auditing claims coding and customer service interactions, the full-time Quality Assurance Specialist will ensure accuracy and compliance with policies while managing complex provider issues and contributing to departmental training remotely.

Key responsibilities:

• Update and complete daily, monthly, and annual reports, and prepare responses to complex provider issues
• Analyze audit reports to identify trends and make recommendations for improvements in quality and workflow processes
• Assist with department training and collaborate on cross-functional projects

Required qualifications:

• Associate's degree or equivalent experience in lieu of a degree
• Four years of related experience in quality assurance or provider data management
• Proficiency in MS Word and MS Excel
• Thorough knowledge of Provider Data Management policies and procedures
• Effective written and verbal communication skills for staff and provider interactions