QA Specialist III - Client Success

📋 Description

• Perform advanced QA reviews of complex overpayment accounts per payer/client requirements.
• Analyze overpayment determinations and documentation for accuracy and quality.
• Serve as SME for QA scenarios, payer requirements, and client processes.
• Identify recurring quality trends, operational risks, and process gaps; recommend improvements.
• Support onboarding and coaching for new team members.
• Collaborate with ops, implementation, and client success on new implementations.

🎯 Requirements

• Bachelor’s degree in business, healthcare, or related field; equivalent healthcare industry experience.
• Experience in healthcare operations, payment integrity, or overpayment recovery.
• Strong understanding of overpayment recovery and payer requirements.
• Excellent analytical skills; ability to evaluate complex data and identify trends.
• Strong communication and collaboration with clients, leadership, and peers.
• Ability to learn new processes quickly and deliver value.

🎁 Benefits

• Competitive pay and growth opportunities.
• Comprehensive health insurance.
• 401(k) with employer match.
• Paid parental leave.
• Professional development and career growth.
• Collaborative and innovative work environment.