Remote Quality Improvement Research Analyst

Avalon Administrative Services LLC; Tampa (FL); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Avalon Healthcare Solutions is seeking a Quality Improvement Research Analyst to support the Quality Department with client inquiries, claims research, and cross‑functional data analysis. The role involves developing client reports, evaluating disputed claims, and driving process improvements.

The ideal candidate has 3+ years in healthcare, strong SQL and Excel skills, and excellent communication. Remote work is allowed with quarterly travel to Tampa, FL.

Qualifications

• Minimum 3+ years in a relevant healthcare field – claims processing, claims coding, customer service, and/or account management
• Bachelor’s degree preferred; 5+ years relevant experience in lieu of a degree
• Previous experience working in a health plan or healthcare services company is required
• Excellent communication and ability to maintain attention to detail with documentation

Responsibilities

• Act as the Quality Subject Matter Expert and support team for service delivery.
• Resolve client inquiries by understanding internal processes and providing timely responses.
• Develop, run, and execute client queries for internal reports.
• Pull and prepare monthly, quarterly, and ad hoc reports for assigned clients.
• Evaluate disputed claims in denial management to facilitate health plan reviews.
• Support the resolution of operational inaccuracies and trends.
• Collaborate with Service Delivery and other internal departments to provide excellent service.
• Understand departmental needs and recommend process improvements.
• Support special assignments and research projects.

Skills

SQL

Excel

Communication

Analytical thinking

Documentation

Team collaboration

Education

Bachelor's degree

Tools

JIRA

Reporting tools

Job description

Avalon Healthcare Solutions is seeking a Quality Improvement Research Analyst to support the Quality Department with client inquiries, claims research, and cross‑functional data analysis. The role involves developing client reports, evaluating disputed claims, and driving process improvements.

The ideal candidate has 3+ years in healthcare, strong SQL and Excel skills, and excellent communication. Remote work is allowed with quarterly travel to Tampa, FL.