Quality Assurance Auditor

🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $48k - $50k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

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Allied Benefit Systems

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1980

⚕️ Healthcare Insurance

🤝 B2B

Healthcare Insurance • B2B

Allied Benefit Systems is a national healthcare solutions company that provides health plan administration, care and cost management, provider network services, and data analytics to employers, members, and benefits consultants. The company focuses on reducing healthcare costs, optimizing plan performance, and improving member experience through administrative services, analytics & insights, and customizable provider networks.

📋 Description

• Log and track data to be audited • Audit outgoing correspondence from the Medical Review, Appeals, and Refund teams • Conduct complete audit of claim adjustments by the Rapid Response team • Communicate and coordinate with other departments involved in the audit process • Audit new and existing plans built by plan coders for all new and existing revisions • Assist with current audit programs in place as well as identify ways to improve audit results • Track and report audit trends and communicate training requirements to Management based on audit results • Monitor and track audit progress to ensure all audit task are complete by the determined deadline • Audit data for accuracy as well as workflow compliance • Other duties as assigned

🎯 Requirements

• Bachelor's degree or equivalent work experience required. • Minimum 5 years of comprehensive experience with auditing medical, dental, and vision claims required. • Proficient in Microsoft Word and Microsoft Excel • Some familiarity with plan coding. • Strong written and verbal communication skills required. • Ability to effectively manage assigned workload, including multiple task and competing priorities.

🏖️ Benefits

• Medical • Dental • Vision • Life & Disability Insurance • Generous Paid Time Off • Tuition Reimbursement • EAP • Technology Stipend