QA - Quality Control, Training, InsuranceLocation:
See RequirementsJob DescriptionABOUT THE POSITION
We are currently seeking a dynamic Claims Quality Coach
to join our team at our office in Morrisville, NC
. The Claims Quality Coach is primarily responsible for reviewing and analyzing, as well as reporting, claims audit review and ensuring quality standards are met for department.Position Responsibilities:
- Performs quality review on a pre-determinedpercentage ofclaims per processoron a daily basis, including priority claims
- Provides professional, accurate and timely feedback to claims processors to reduce errors and improve processes and performance
- Mentors new claims processors andserves as subject matter expert
- Reviews internal/client audit refutes on an as needed basis
- Works with Training, Claims Supervisors and Manager to identify areas of improvement and ways to implement them within the claims team.
- Collection and analysis of data elements related to systemic problems or processor error
- Provides claims support when needed by reviewing, researching and investigating claims
- Generates reports detailing quality findings and trend analysis
: High school diploma or equivalent required. Licensure
: n/aRelevant Work Experience:
Three (3) to five (5) years of relevant claims processing experience required.Knowledge, Skills & Abilities
- Strong computer skills required, including Word, Excel and Outlook
- Prior experience with NASCO and Service Connect preferred
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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.
PM16 Job Requirements
Location/Region: Morrisville, NC (US - 27560)