Monitors and records the quality of work performed by Claim teams within the Operations Department for pre-payment of claims and claims audits, for all regions in all lines of business. Identify trends in specific errors and error rates. Determines and recommends needs for retraining, or clarification of work procedures. Develops and produces, periodic reports based on audits/projects completed, for the Quality Control Supervisor. Presents these reports, as needed to specific supervisors and mangers within the Operations Department. Research, identify and corrects deficiencies related to work quality, work flow or specific quality issues. Performs other duties as assigned
" Associates' degree preferred or directly related business experience.
" New York State Independent Adjusters license, or the ability to obtain a NYS Independent Adjusters license
Minimum Experience: Proven track record of claims processing/auditing experience consistently exceeding quality requirements.
" Previous Quality Assurance experience preferred.
" Working experience with MS Office (Access, Excel, Word) strongly preferred.
" Good written and verbal communication skills.
" Proven organizational and analytic skills.
" Attention to detail and commitment to quality service required.
MVP Health Care - 7 months ago
MVP Health Plan covers about 650,000 most valuable people. Also known as MVP Health Care, the company provides health insurance and employee...