Healthcare Quality Assurance Specialist

TEKsystems; Cleveland (OH); Remote; USD 80,000 - 100,000; Full time

Job summary

A forward-thinking company is seeking Health Insurance Quality Assurance Specialists for a fully remote role. This position involves meticulously testing benefit plans to ensure compliance with client specifications. The ideal candidate will possess strong Excel skills and a background in healthcare insurance. Attention to detail is paramount, as the role includes identifying and resolving discrepancies without phone work. Join a dynamic team dedicated to enhancing business outcomes and community impact while enjoying comprehensive benefits and a flexible work environment.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Retirement Plan

Life Insurance

Short and Long-Term Disability

Health Spending Account (HSA)

Transportation Benefits

Employee Assistance Program

Paid Time Off (PTO)

Qualifications

• Minimum 1 year of Excel experience, strong research skills are valued.
• 2-4 year degree preferred in relevant fields.

Responsibilities

• Quality testing of benefit plans, ensuring they meet client specifications.
• Coordinate with AIS group to resolve discrepancies.

Skills

Excel

Research Skills

Healthcare Insurance Knowledge

Medical Terminology

Education

Two or Four-Year Degree

Job description

*TEKsystems is actively hiring for Health Insurance Quality Assurance Specialists for a renowned health insurance company in Minnesota! Fully Remote Non-IT Position

Start Date: June 16th, 2025

Description

This role involves quality testing all benefit plans. The specialist will collaborate with the Account Install Specialist team during plan development, ensuring the plans are built correctly according to client specifications. If discrepancies such as incorrect deductibles, out-of-pocket limits, or pricing are identified, the specialist will coordinate with the AIS group to resolve these issues. Attention to detail is crucial; there is no phone work involved. Communication will primarily be internal via email or messaging, and a scorecard will be provided post-training. The expected workload is 25 plans per week.

Skills & Qualifications

Minimum requirements:

• Two or four-year degree (preferably in Math, Biology, Business, Healthcare Administration, or History; strong research skills are valued)
• At least 1 year of Excel experience (excluding VLOOKUPs or Pivot Tables)

Preferred experience:

• 3+ years of healthcare insurance experience
• Knowledge of medical terminology, deductibles, copays, and provider language
• Experience in a production environment is a plus

Pay and Benefits

The pay rate is $24.00 per hour. Benefits may include:

• Medical, dental, and vision insurance
• Critical illness, accident, and hospital coverage
• 401(k) retirement plan with pre-tax and Roth options
• Life insurance (voluntary for employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Paid Time Off (PTO, vacation, sick leave)

Workplace Type

This is a fully remote position.

Application Deadline

Applications are accepted until May 20, 2025.

About TEKsystems

TEKsystems is a leading provider of business and technology services, helping accelerate business transformation through strategy, design, execution, and operations. With a global team of 80,000+ professionals, we serve over 6,000 customers, including 80% of the Fortune 500. We are committed to delivering business outcomes and positive community impacts. TEKsystems and TEKsystems Global Services are part of Allegis Group. Learn more at TEKsystems.com.

The company is an equal opportunity employer, considering all applications regardless of race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, or genetic information.