Quality Assurance Specialist - Hiregy

JOB ID 20277 – Quality Assurance Specialist

Location:  Fully remote, must be local to Lake Mary for equipment pickup

Pay:  $21.25 per hour

Type:  Contract, until approximately 2/15/2025

Schedule:  M-F 9-6 EST through Dec
January and beyond may have different shift hours will between 8am to 8pm EST
In January, shifts can move around usually 90% fixed

Start date:  10/28/2024

Summary:  This position is data verification, not call monitoring.  Reviewing case data daily. 

Job description:

• Perform quality assurance initiatives by reviewing daily benefit verifications for completeness and accuracy, ensuring adherence to established standards.
• Update quality documentation as needed to reflect current practices and protocols.
• Provide feedback to supervisors based on quality control evaluations and assist in identifying areas for improvement.
• Meet daily quotas for the number of benefit verifications reviewed, maintaining efficiency while upholding quality standards.
• Document evaluations using departmental quality monitoring templates and participate in calibration meetings to ensure consistent application of expectations and standards.

Nice to have:

• Benefits verification
• Prior authorizations
• Revenue cycle
• Medical billing

Requirements:

• Must have at least 1-2 years of experience performing benefit investigations or closely aligned medical and insurance work.
• Must have knowledge of medical terminology.
• Must have a private designated workspace.
• High school diploma or equivalent.
• Employment verification required.
• Education verification required.
• Background check required.