Remote Quality Assurance Specialist – Claims & Compliance

GEHA Health; Lee's Summit (MO); À distance; USD 48 000 - 60 000; Plein temps

Avantages offerts par ce poste

Health benefits

Dental benefits

Vision benefits

401(k) match

PTO

Tuition assistance

Résumé du poste

GEHA Health is seeking a Quality Assurance Specialist for a remote role focused on auditing claims, calls, and electronic files to ensure accuracy and policy compliance. The position supports Provider Data Management and requires strong communication with staff and providers.

The ideal candidate has an associate degree or equivalent experience, 4+ years in related QA, and solid MS Word/Excel skills. The role offers competitive pay, benefits from day one, and growth opportunities within the

Qualifications

• Associate degree or equivalent experience required.
• Minimum 4 years of related QA experience.
• Proficiency with MS Word and MS Excel.

Responsabilités

• Audits claims coding, customer service calls, or electronic files for accuracy.
• Reviews benefit payments and contract interpretation for compliance.
• Responds to provider issues and questions from PDM staff.
• Analyzes audit reports and trends to improve quality and policies.
• Assists with department training and cross-functional projects.
• Reviews training materials and desk-level procedures for updates.

Connaissances

MS Word

MS Excel

Effective communication

Associate degree experience

Formation

Associate's degree or equivalent experience

Outils

Provider Data Management

Description du poste

GEHA Health is seeking a Quality Assurance Specialist for a remote role focused on auditing claims, calls, and electronic files to ensure accuracy and policy compliance. The position supports Provider Data Management and requires strong communication with staff and providers.

The ideal candidate has an associate degree or equivalent experience, 4+ years in related QA, and solid MS Word/Excel skills. The role offers competitive pay, benefits from day one, and growth opportunities within the