Quality Assurance Specialist III

Remote Full-time
Job Title: Quality Assurance Specialist III

Location: Remote Job

Duration: 3 Months with possible contract to hire

Only on W2

Local TO DMV location candidates only

Description:

Purpose:

The Quality Assurance Specialist III is an advanced-level auditor position performing in-depth system and procedural audits. This role conducts regular reviews and audits of internal controls within each functional area for strengths and weaknesses ensuring special focus to the specific risk areas. The incumbent is considered a Subject Matter Expert (SME) in their audit field and provides a comprehensive analysis of transaction, systems and procedures.

Essential functions:

50% Audits assigned function (service, claims, enrollment) for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Identifies, documents and reports transaction errors utilizing departmental quality monitoring templates in a timely manner to ensure prompt resolution

20% Assists in development of special department projects and participates in department and divisional projects

20% Conducts structured coaching and feedback sessions. Provides suggestions and creates improvement plans for areas of deficiency within the group or for an individual

10% Participates in the creation and implementation of new methods, processes and/or products

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Experience:

5 years Auditing, Quality Assurance, Operations, Training, Project Management or comparable work experience

2 years experience as Quality Assurance Specialist II

Preferred qualifications

Knowledge, Skills and Abilities (KSAs)

Knowledge of quality assurance and production technologies., Expert

Proficient in Microsoft Office programs., Proficient

Extensive of industry standards, quality control techniques and procedures., Advanced

Excellent communication skills both written and verbal., Advanced

Extensive analytical and problem solving skills, Advanced

Strong interpersonal skills, Advanced

Excellent research and organizational skills, Advanced

Licenses/certifications

ECA Certified Quality Assurance Manager

Additional skills:

Coding certification (CPC or COC, CPMA et., Claims and insurance experience. Medical records auditing

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