Senior Quality Assurance Analyst
Pocono Medical Center
Allentown , PA 18101
Posted 7 months ago
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Job Summary: The Senior Quality Assurance Analyst is responsible for leading the auditing and quality assurance effort for the Group Health Department.
In collaboration with the Manager, Group Health Operations, this individual is responsible for ensuring the adequacy of auditing efforts to meet industry standards tied to sample size, types of transactions/claims audited and audit frequency. A key contributor to the identification of training needs, service achievements or gaps, and staff development, this individual is expected to be focused on performance quality, colleague success and client/contract satisfaction. The Senior QA Analyst will interface with a variety of colleagues in the department including the operations specialist, processing analysts, claims supervisors/leads and will offer direction and counsel to the Group Health Claims Auditing # Processing Support Specialist.
Minimum Requirements: Requires the individual to work independently with minimal supervision. Requires the ability to function under the pressure of frequent deadlines.
Requires a high degree of professional judgment and interpersonal skills at all levels and among all disciplines.
Medical and dental claims processing experience.
Familiarity with third party administration. Licensure and Certifications:#No