Quality Assurance Reviewer

Fusion Advanced Technology, LLC; Baltimore (MD); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Team focused on operational excellence

Job summary

Fusion Advanced Technology, LLC in Baltimore is seeking a QA reviewer to support audits and pre-authorization reviews. You will review records against QA criteria, document defects, track trends, and escalate issues while supporting monthly reporting and training needs.

Ideal candidates have 3+ years in quality review or related analytical operations and familiarity with public program files, with a preference for Maryland experience.

Qualifications

• Associate or bachelor’s degree preferred.
• 3+ years in quality review or related analytical operations.
• 1+ year in QA review or compliance checking.
• Experience with Maryland public programs is a plus.

Responsibilities

• Review customer, provider, case, and payment records against QA criteria and control standards.
• Document defects, observations, trends, and required follow-up actions clearly.
• Support 100% or targeted pre-authorization reviews where required.
• Track repeat findings and assist with monthly reporting and evidence preparation.
• Escalate suspected integrity issues, policy deviations, or systemic problems.
• Assist operations leaders and trainers by identifying error patterns and training needs.

Skills

Quality review

Audit support

File review

Claims review

Eligibility review

Compliance checking

Operational analysis

Education

Associate or Bachelor's degree

Job description

Core responsibilities

• Review customer, provider, case, and payment records against QA criteria and control standards.
• Document defects, observations, trends, and required follow-up actions clearly.
• Support 100% or targeted pre-authorization reviews where required.
• Track repeat findings and assist with monthly reporting and evidence preparation.
• Escalate suspected integrity issues, policy deviations, or systemic problems.
• Assist operations leaders and trainers by identifying error patterns and training needs.

Recommended minimum qualifications

Associate degree or bachelor’s degree preferred. Three or more years of quality review, audit support, file review, claims review, eligibility review, compliance checking, or similar analytical operational experience.

Minimum years of experience criteria

• 3+ years total relevant experience
• 1+ year in QA review, compliance checking, audit support, file review, or operational quality control.
• Direct public assistance, childcare subsidy, Maryland public program, or regulated operational review experience preferred.

Preferred qualifications

• Experience reviewing public program cases or payments for timeliness, accuracy, and policy compliance.
• Experience using scorecards, review forms, or audit tools.
• Experience writing concise findings and communicating them to operations teams.
• Experience with Maryland systems or public program files is a plus.

Benefits

Fusion offers a competitive benefits package that includes medical, dental, and vision coverage.

Join a team committed to operational excellence, and mission success.

Equal Employment Opportunity

In order to provide equal employment and advancement opportunities to all individuals, employment decisions will be based on merit, qualifications, and abilities. Fusion Advanced Technology does not discriminate against any person because of race, color, creed, religion, sex, national origin, disability, age, genetic information, or any other characteristic protected by law (referred to as “protected status”). This nondiscrimination policy extends to all terms, conditions, and privileges of employment as well as the use of all company facilities, participation in all company-sponsored activities, and all employment actions such as promotions, compensation, benefits, and termination of employment.

This job description is intended to outline the general nature and level of work being performed. It is not intended to be a comprehensive list of all responsibilities, duties and skills required of the position. Additional tasks may be assigned as needed.