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Quality Assurance Specialist - Medical Claims

Remote, USA Full-time Posted 2026-06-17

Employer Industry: Healthcare Technology Why consider this job opportunity... - Salary up to $55,000 - Eligible for health, dental, vision, and mental health benefits - Opportunity for career advancement and growth within the organization - Supportive and diverse work environment that celebrates differences - Chance to make a positive impact on the claims process and overall member wellbeing What to Expect (Job Responsibilities): - Review internal procedures and analyze claims data to identify and correct incorrectly paid claims - Record and track quality assessment scores while providing feedback to reduce errors - Monitor departmental performance and support the implementation of process improvements - Assist with the development of document control related to the Quality Assurance system - Ensure compliance with HIPAA regulations regarding the privacy and security of Protected Health Information (PHI) What is Required (Qualifications): - High school diploma or equivalent (GED) - Knowledge of medical terminology, including ICD-9, CPT & HCPCS coding - Healthcare or claims processing experience - Proficient in Microsoft Word, Excel, and Outlook - Strong organizational skills with the ability to manage time effectively in a fast-paced environment How to Stand Out (Preferred Qualifications): - Excellent written and verbal communication skills - Ability to work independently with sound judgment - Highly organized and detail-oriented with extreme accuracy - Experience in quality assurance or auditing processes within healthcare #HealthcareTechnology #QualityAssurance #ClaimsProcessing #CareerOpportunity #DiversityAndInclusion At Talentify, we prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. Talentify is not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer Apply Job!

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