Claims Quality Inspector
A company is looking for a Claims Quality Inspector. Key Responsibilities: Conduct accurate and timely quality reviews of claim adjudication activities Perform quality audits on Membership eligibility and enrollment entry Document findings in QC tracking system and communicate error determinations Required Qualifications: High School Diploma or GED required At least 2 years of experience in a Claims or QC/Inspector role within the managed care industry, or 5 years processing medical claims Bachelor's degree and/or Claims adjudication or medical billing/coding certification preferred Prior experience within the Medicare, Medicaid, or regulated Managed Care payer environment is desirable Pre-employment background check required
A company is looking for a Claims Quality Inspector.
Key Responsibilities:
Conduct accurate and timely quality reviews of claim adjudication activities
Perform quality audits on Membership eligibility and enrollment entry
Document findings in QC tracking system and communicate error determinations
Required Qualifications:
High School Diploma or GED required
At least 2 years of experience in a Claims or QC/Inspector role within the managed care industry, or 5 years processing medical claims
Bachelor's degree and/or Claims adjudication or medical billing/coding certification preferred
Prior experience within the Medicare, Medicaid, or regulated Managed Care payer environment is desirable
Pre-employment background check required
