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Quality Control Analyst
A company is looking for a Quality Control Analyst - Remote. Key Responsibilities Audit claims for accuracy, including complex and high dollar claims, and review dispute requests from providers Identify system configuration issues affecting claims processing and communicate with relevant internal departments Create detailed audit findings and recommendations, and conduct retrospective audits of paid claims Required Qualifications High school diploma or equivalent required; Bachelor's degree in Finance or Accounting preferred 5 years of experience as a Quality Control Analyst 2-3 years of experience as a Claims Adjuster Strong knowledge of Managed Healthcare and coding regulations (CPT, RBRVS, DRG, HCPCS, ICD-9, ICD-10) No certification required
A company is looking for a Quality Control Analyst - Remote.
Key Responsibilities
Audit claims for accuracy, including complex and high dollar claims, and review dispute requests from providers
Identify system configuration issues affecting claims processing and communicate with relevant internal departments
Create detailed audit findings and recommendations, and conduct retrospective audits of paid claims
Required Qualifications
High school diploma or equivalent required; Bachelor's degree in Finance or Accounting preferred
5 years of experience as a Quality Control Analyst
2-3 years of experience as a Claims Adjuster
Strong knowledge of Managed Healthcare and coding regulations (CPT, RBRVS, DRG, HCPCS, ICD-9, ICD-10)
No certification required