Hybrid Health Membership Quality Auditor

Page Mechanical Group, Inc.; Portland (OR); Ibrido; USD 32.000 - 36.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, Dental, Vision, Pharmacy,Life

Disability

401K- Matching

FSA

Employee Assistance Program

PTO and Holidays

Descrizione del lavoro

Moda Health, founded in Oregon, seeks a Quality Assurance auditor to perform accurate auditing of pre/post enrollment, billing, and reconciliation. The role tracks quality trends across specialists and departments, with emphasis on compliance and continuous improvement.

The position is full-time, hybrid in Portland, OR, offering comprehensive benefits and family-friendly PTO. Candidates should have 1–2 years of health insurance QA experience and strong MS Word/Excel skills to support daily

Competenze

• High School diploma or equivalent required.
• 1-2 years quality review experience in a health insurance environment preferred.
• Demonstrate strong, effective, and diplomatic interpersonal skills with employees at all levels.
• Knowledge of Word, Excel, and ability to navigate web-based programs.
• Excellent reading, verbal, and written communication skills.
• Good analytical, problem solving, organizational, and detail-oriented skills.

Mansioni

• Audit enrollments, billings and reconciliation daily using sampling methodology and prescribed criteria.
• Ensure QA standards and regulations are adhered to through auditing duties.
• Conduct in-depth enrollment, billing, and reconciliation audits for performance groups and specific situations.
• Prepare monthly/quarterly reports for group performance guarantees and accuracy results.
• Identify trends from audits and recommend quality improvements.
• Create and update documentation and department procedures as needed.
• Support the company’s quality initiatives and promote a team-oriented environment.
• Maintain confidentiality and professional appearance in all interactions.

Conoscenze

Quality review

Interpersonal skills

Word/Excel

Communication

Attention to detail

Formazione

High School diploma or equivalent

Strumenti

Word

Excel

Descrizione del lavoro

Moda Health, founded in Oregon, seeks a Quality Assurance auditor to perform accurate auditing of pre/post enrollment, billing, and reconciliation. The role tracks quality trends across specialists and departments, with emphasis on compliance and continuous improvement.

The position is full-time, hybrid in Portland, OR, offering comprehensive benefits and family-friendly PTO. Candidates should have 1–2 years of health insurance QA experience and strong MS Word/Excel skills to support daily