Remote Healthcare Claims QA Analyst

Integra Partners; Northern (KY); Hybrid; USD 27,000 - 39,000; Full time

Benefits offered by this job

Competitive compensation and bonus

401(k) with company match

Life insurance

Disability coverage

Medical, Vision, and Dental benefits

PTO and parental leave

Paid holidays and floating holidays

Wellness programs

Career development opportunities

Job summary

Integra Partners is seeking a Claims Quality Assurance Analyst to monitor and document production quality within the Revenue Cycle Management function, with a focus on audits and claims‑related interactions. The role supports design of quality standards and presents results to leadership to drive improvements.

The ideal candidate has knowledge of billing practices, state requirements, and healthcare QA; DME experience is preferred.

Qualifications

• Minimum 1 year of claims auditing experience across commercial, Medicaid and Medicare; DME preferred.
• Knowledge of Revenue Cycle Management (RCM) workflows and related impacts across lines of business.
• Proven track record of quality and production scores (≥95%).
• Understanding of QA methodologies and quality monitoring practices.
• Ability to analyze data to identify root causes and propose solutions.
• Strong communication skills, both in writing and speaking, and the ability to coach others.

Responsibilities

• Monitor Claims quality and audit functions; support other departments as needed.
• Design and maintain quality monitoring forms and standards.
• Record evaluations using departmental forms and report findings to leadership.
• Conduct claims audit reviews for accuracy, documentation, workflow adherence, and compliance.
• Evaluate billing practices with attention to state-specific requirements.
• Identify audit findings and collaborate with operations to reduce defects.
• Prepare quality reports for management review and trend analysis.
• Lead calibration sessions and present insights to department leads.
• Develop training content to improve skills across operations.
• Support cross-departmental quality monitoring and ad hoc analyses.

Skills

Claims auditing

Quality assurance

Data analysis

Verbal and written communication

Cross-department collaboration

Bilingual: Spanish/English

Education

Bachelor’s Degree or equivalent

Tools

Excel

Genie QA platform

Word

PowerPoint

Job description

Integra Partners is seeking a Claims Quality Assurance Analyst to monitor and document production quality within the Revenue Cycle Management function, with a focus on audits and claims‑related interactions. The role supports design of quality standards and presents results to leadership to drive improvements.

The ideal candidate has knowledge of billing practices, state requirements, and healthcare QA; DME experience is preferred.