Healthcare Quality Assurance Specialist

TEKsystems; Philadelphia (Philadelphia County); Remote; USD 60,000 - 80,000; Full time

Job summary

A forward-thinking company is seeking Health Insurance Quality Assurance Specialists for a fully remote role. This position focuses on ensuring the accuracy of benefit plans, requiring a keen eye for detail and strong communication skills. The specialist will work closely with the Account Install Specialist team, verifying plans across multiple systems and addressing any discrepancies. Ideal candidates will have a degree in a relevant field and experience in healthcare insurance. Join a dynamic team dedicated to providing quality service in the health insurance sector.

Benefits

Medical, Dental & Vision Insurance

401(k) with Pre-tax and Roth Options

Paid Time Off (PTO)

Employee Assistance Program

Transportation Benefits

Qualifications

• Degree in Math, Biology, Business, Healthcare Admin, or History preferred.
• 1 year of Excel experience required.

Responsibilities

• Quality testing of benefit plans for accuracy across systems.
• Coordinate with AIS group to resolve discrepancies.

Skills

Excel

Healthcare Insurance Knowledge

Attention to Detail

Communication Skills

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 of benefit plans. The specialist will collaborate with the Account Install Specialist team during plan development. They will verify the accuracy of the plan across multiple systems, ensuring it meets client specifications. If discrepancies are found, they will coordinate with the AIS group to resolve issues. Common issues include incorrect deductibles, out-of-pocket limits, and mail pricing discrepancies. The role requires high attention to detail, with no phone work involved. Communication is primarily internal via email or messaging. Post-training, a scorecard will be used to track performance, with an expectation of processing 25 plans per week. This is a non-IT role.

Skills & Qualifications:

Minimum requirements:

• Two or four-year degree (preferably in Math, Biology, Business, Healthcare Admin, or History; heavy research experience is a plus)
• 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 advantageous

Pay and Benefits

The pay rate is $24.00/hr. Benefits, subject to eligibility and specific plan terms, may include:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital coverage
• 401(k) with pre-tax and Roth options
• Voluntary Life & AD&D Insurance
• Disability coverage
• 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

May 20, 2025

About TEKsystems

TEKsystems is a leading provider of business and technology services, helping clients accelerate transformation through strategy, design, execution, and operations. With 80,000 employees serving over 6,000 clients worldwide, including 80% of the Fortune 500, we are committed to delivering business value 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 and values diversity. All applications will be considered without regard to race, sex, age, religion, or other protected characteristics.