Spec, Quality Assurance III

Our Client, a Health Insurance company, is looking for a Spec, Quality Assurance III for their Remote location. Responsibilities:

• 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.
• 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

Requirements:

• Education Level: High School Diploma
• Education Details: or GED
• 5 years Auditing, Quality Assurance, Operations, Training, Project Management or comparable work experience
• 2 years experience as Quality Assurance Specialist II
• 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
• The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs. Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
• ECA Certified Quality Assurance Manager
• Coding certification (CPC or COC, CPMA et., Claims and insurance experience. Medical records auditing

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws. Remote Benefits: 401K, Employee Referral Program, Life Insurance About the Company: Iconma ICONMA is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.

• Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.
• Certified Woman-Owned Business Enterprise (WBE); certified by Women’s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).
• Founded in 2000
• 2000+ Employees

The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage. Company Size: 2,000 to 2,499 employees Industry: Management Consulting Services Founded: 2000 Website: https://www.iconma.com/ Apply tot his job Apply To this Job