A company is looking for a Senior Quality Analyst who will oversee contract and benefit configuration to ensure accurate claims processing and network compliance.
Key Responsibilities
Audit system configuration against contract requirements
Collaborate with IT and operations to resolve claims configuration gaps
Perform routine and complex audits of claim transactions to validate results
Required Qualifications
5+ years of advanced claims adjudication experience
Minimum 3 years in auditing of claims adjudication
Working knowledge of medical terminologies and coding
Experience with building and running SQL queries
Strong organizational skills and ability to multitask
Quality Analyst • Saint Paul, Minnesota, United States