Remote Claims Quality Assurance Analyst

Vaya Health; North Carolina; Remote; USD 43,000 - 56,000; Full time

Job summary

Vaya Health remote-based role seeks a Claims Quality Assurance Analyst to conduct weekly quality reviews of the Claims and Reimbursement department’s work processes. You will identify trends, provide feedback to management, and support onboarding of new employees with coaching and training.

The position requires strong attention to detail, excellent communication, and the ability to work both independently and as part of a team. The role is home-based with EST hours.

Qualifications

• Minimum 5 years of combined healthcare claims processing experience or an Associate Degree with 2 years of post-degree experience.
• Experience with Medicaid/Medicare and other third-party payment sources is required.
• Excellent attention to detail and strong written/verbal communication.

Responsibilities

• Audit a random weekly sample of claim and enrollment work to ensure accuracy and completeness.
• Document audit findings by type and area, and prepare reports for internal partners.
• Provide onboarding support through feedback and training for new staff.
• Collaborate with other departments to identify process gaps and system deficiencies.

Skills

Attention to detail

Analytical thinking

Communication skills

Time management

Independent working

Education

High School Diploma or GED

Associate Degree

Tools

Microsoft Word

Excel

Outlook

SharePoint

NC Tracks

Job description

Vaya Health remote-based role seeks a Claims Quality Assurance Analyst to conduct weekly quality reviews of the Claims and Reimbursement department’s work processes. You will identify trends, provide feedback to management, and support onboarding of new employees with coaching and training.

The position requires strong attention to detail, excellent communication, and the ability to work both independently and as part of a team. The role is home-based with EST hours.