Claims Quality Assurance

📋 Description

• Serve as QA expert for claims by evaluating standards and client needs.
• Audit claim files on coverage, valuation, compliance, and disposition.
• Lead QA projects with operational teams and leadership.
• Support quality improvement strategies and corrective actions.
• Create and maintain QA training programs and calibration sessions.
• Analyze quality trends to identify risks and improvements.

🎯 Requirements

• Bachelor’s degree in Business Admin, Insurance, Healthcare, or related field, or equivalent
• 5+ years in claims management or similar environment.
• Strong knowledge of end-to-end claims processes and regulatory requirements.
• Experience with QA reviews, audits, training, or process improvements.
• Analytical, quantitative, and problem-solving skills.
• Excellent written and verbal communication; ability to collaborate.

🎁 Benefits

• Competitive salary range of $70,276 – $116,942
• Fully remote work opportunity
• Healthcare, HSA/FSA options, life and disability insurance
• 401(k) and Roth 401(k) plans
• Paid time off and wellness benefits
• Career advancement opportunities