Claims Quality Specialist

VirtualVocations
Durham, North Carolina, United States
Full-time

A company is looking for a Specialist, Claims Quality Regulatory Operations to join their Claims Quality team.Key ResponsibilitiesCollaborate with team members to identify process gaps and improvementsConduct data analysis to support compliance initiatives and prepare reportsAssist in preparing for regulatory reviews and maintain up-to-date policies and proceduresRequired Qualifications1+ years of relevant experience in operational compliance and data analysis within Healthcare ClaimsDemonstrated understanding of Provider operations in the health payer industryExperience in designing and improving workflows1+ years experience using data software to analyze large data setsKnowledge of regulatory bodies and Market Conduct Exams is a plus

4 days ago
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