Job Summary
A health insurance company is in need of a Remote Chinese QA Auditor.
Core Responsibilities Include:
- Conducting quality audits of Operational processes for internal employees and outsourced vendors such as authorizations, provider claims, pre and post payments, sources of information, incoming/ outgoing calls, pre/post-service appeals, etc
- Analyzing errors and determine root causes for appropriate classification
- Presenting results of investigations to senior staff and prepare written reports concerning investigation activities
Applicants must meet the following qualifications:
- High School Diploma or GED from an accredited institution
- Bilingual skills with Chinese and English
- Experience in an Auditing capacity conducting root cause analysis
- Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family
- Experience in Microsoft Office suite of applications including Excel (formatting formulas, managing data, and filtering results), Word (creating and editing documents), PowerPoint (creating and editing presentations)
