Job Summary
A health care provider is filling a position for a Remote Government Products Quality Assurance Reviewer III in Pittsburgh.
Individual must be able to fulfill the following responsibilities:
- Perform quality review on all types of claims
- Develop and maintains auditing tools
- Maintain or exceeds designated quality and production goals
Position Requirements Include:
- Bachelor's degree or equivalent education and experience
- Five to seven (5-7) years health insurance operations experience required
- Ability to maintain designated production standards, multiple projects and tasks
- Extensive knowledge of medical terminology, ICD-9 and CPT-4 coding
- Extensive knowledge of HMO, POS and PPO plans
- High degree of oral and written communication skills
