Healthcare Quality Assurance Specialist – SCA

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🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔧 QA Engineer (Quality Assurance)

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Machinify

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

🤖 Artificial Intelligence

☁️ SaaS

💰 $10M Series A - Machinify on 2018-10

Healthcare Insurance • Artificial Intelligence • SaaS

Machinify is a healthcare-focused AI platform and services company that reshapes healthcare payments and payment integrity. Its AI operating system unifies claims, medical records, contracts, and policies, and uses foundation models and task-specific agents to automate and improve coding, payment accuracy, recoveries, and cost avoidance. Machinify serves health plans (including 18 of the top 20), supports insourced, hybrid, or fully-managed deployments, and emphasizes measurable outcomes — reporting 85+ customers, 270M member lives covered, and $6B+ in annual cost avoidance and recoveries.

📋 Description

• Provide support to the departmental quality assurance program • Perform quality reviews work assignment tasks related to specific departmental workflows • Use available tools to gather data and analyze trends or patterns affecting quality; highlight key successes and share best practices with staff • Identify areas of improvements and collaborate with departmental leadership team members to streamline processes • Provide structured and timely recommendations through verbal and/or written feedback to leadership team • Provide direct individual coaching/feedback to team members using specific examples highlighting performance strengths as well as areas of improvement needed • Develop and conduct targeted group coaching sessions that address quality deficiencies and/or improvement opportunities • Assist with creation of training materials and related duties as assigned • Assess new hires after training to determine readiness for moving into support • Observe and comply with all company and mandated rules, regulations, and protocols • Select a quality sample for assigned staff members; conduct timely QA reviews • Run QA reports summarizing results of QA conducted by staff members, team and department • Follow Quality standard operating procedures • Perform other duties as assigned

🎯 Requirements

• Ability to obtain and maintain client required clearances as well as pass company regular background and/or drug screening. • Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety&ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

🏖️ Benefits

• Equal Employment Opportunity • Regular background and/or drug screening