Claims Quality Assurance Analyst

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them.

You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

As the Claims Quality Assurance Analyst , you will be responsible for monitoring and auditing access to all internal systems, conducting various audits related to claims, systems, business, and project requirement rules.

Responsibilities :

• Monitoring and auditing access to all internal systems.
• Conducting audits related to claims, system business, and project requirement rules.
• Monitoring projects for defects or potential errors.
• Managing RCA and CAP for the project during audits.
• Ensuring that documented policies, procedures, and workflows are maintained.
• Utilizing experience with data warehouse to enhance data quality and analysis.
• Performing outreach and education sessions for Maryland Medicaid Providers.

Qualifications :

• Possess bachelor’s degree in information technology, Computer Science, or a related field.
• Have a minimum of 3 years of experience in IT Quality Assurance or a related role.
• Show strong knowledge of Change and Release Management processes.
• Possess experience with data warehouse and its applications.
• Demonstrate proficiency with MS Office Suite.
• Have excellent analytical and problem-solving skills.
• Exhibit strong communication and interpersonal skills.
• Show experience with PBM (Pharmacy Benefit Management), Medicaid, and Medicare desired.
• Able to travel and attend in-person state meetings as required.

Flexible Working

At Conduent, we want you to be yourself. We recognize that everyone is different and that how people want to work and deliver at their best is different for everyone too.

In this role, you can expect the following working conditions :

Remote work : Enjoy the convenience of working from home and maximize your time by unplugging at the end of your workday.

Working For You

Perks and rewards designed for you :

• Health and Welfare Benefits : Our health and welfare benefits can be tailored to fit you and your family's needs and start on the first day of employment.
• Retirement Savings : We will support you as you save for your future.
• Employee Discounts : We offer you access to a vast selection of global, national, and local discounts on merchandise, services, travel, and more.
• Career Growth Opportunities : We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
• Paid Training : Earn while you learn and continue to grow with access to award-winning learning platforms throughout your Conduent career.
• Paid time off : We provide attractive paid time off packages designed for you to enjoy your life away from work.
• Great Work Environment : We are proud of our award-winning culture and the recognition we’ve received for our diversity efforts.
14 days ago