Quality Assurance Specialist 2, PCU

Job not on LinkedIn

🔥 1 hour ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

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Dayforce

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

👥 HR Tech

☁️ SaaS

🏢 Enterprise

💰 $1G Post-IPO Debt - Dayforce on 2024-03

HR Tech • SaaS • Enterprise

Dayforce is a cloud-based human capital management (HCM) platform that delivers integrated payroll, HR, workforce management, talent management, and benefits administration for employers. It is offered as a software-as-a-service (SaaS) solution designed to help organizations manage employee lifecycle processes, payroll and scheduling in a unified system.

📋 Description

• Review all policy administration and claim level transactions against the standard operating procedures. • Maintain the review of all Daily and Monthly billing suspense items. • Responsible for reviewing benefit eligibility determinations to ensure that the claim recommendations meet the contractual obligations of the policy. • Assign and document all mechanical and financial errors as discovered. • Maintains a strong working knowledge base of all Long-Term care products and services. • Maintain production and quality standards established in the department. • Participate and support policy review decisions in the appeal process. • Monthly reporting to all engagement managers and supervisory staff on the quality results of their department and staff • Participate in client level meetings. Create action plans as agreed upon with the client and meet all timelines and deliverables. • Complying with company regulations regarding HIPAA, confidentiality, and private health information. • Other duties may be assigned. • Ability and Flexibility to work overtime as required.

🎯 Requirements

• In-depth insurance knowledge. Focus on Long Term Care Insurance and Benefit Eligibility determinations a plus. • Promote an exceptional level of excellence and pride in Customer Service • Integrity/Honesty • Sound interpersonal and communication skills • Motivation • Ability to multi-task • Meticulous attention to detail • Ability to lead others through performance and professionalism. • Ability to work in a fast-paced environment. • Highly developed problem-solving skills. • Organizational/Planning/Organizing • Proficiency in basic computer applications is required. (MS Word, MS Excel