Quality Analyst, Grievance and Appeals
Job Description: • Applies in-depth knowledge of subject matter and independently coaches others on matters regarding complaints and appeals • Ensures compliance with federal and/or state regulations • Prepares and participates in external and internal audits • Analyzes quality and completeness of documentation • Contributes to process improvements by recommending changes • Assists in analyzing patterns, trends, and systemic issues • Compiles reports on quality metrics • Facilitates inquiries and maintaining a customer-centric approach • Acts as a liaison between the organization and relevant individuals Requirements: • 1+ years of Compliance experience • 1+ years of External Audit Experience • 1+ years of Grievance and Appeals Experience • 1+ Medicare and/or Medicaid experience • High School Diploma or GED Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings • Tobacco cessation and weight management programs • Confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access Apply tot his job