Group Health QA Specialist

Job Description

The QA Specialist is crucial in the review process, acting as a bridge between customers, reviewers, and management to ensure reports are completed by the requested due date. They ensure reports are timely, complete, clinically accurate, and meet customer requirements and company standards. The QA Specialist improves processes and increases efficiency. They give regular status updates to the client, evaluates report quality, and ensure it meets all standards. Also, they clarify ambiguous questions, distribute final reports, and coordinate & execute clarification & addendum requests. The QA Specialist also participates in phone calls or meetings with clients when needed and follow up for any missing information. Moreover, they work directly with physicians to answer client questions and ensure on-time report delivery. They provide feedback on report quality and request clarifications, and confirms doctor approval for the final report. They review each report for data accuracy, grammar, and punctuation. They ensure all state requirements are met and adhere to client-specific requirements. The QA Specialist also ensures client special handling instructions are followed. In addition, they provide oversight to team members, improves processes, and acts as a liaison for quality issues. The QA Specialist is responsible for the final approval on cases for release to the client and handles other duties and special projects as needed.

Qualifications

1. An Associate’s Degree or Bachelor’s Degree is preferred. 2. Business experience in a healthcare and/or insurance setting is preferred. 3. Present exceptional communication skills with a clear understanding of company business lines. 4. The ability to apply critical thinking, manage time efficiently and meet specific deadlines. 5. Computer literacy and typing skills are essential. 6. Any lifting, bending, traveling, etc. required to do the job duties listed above. 7. Long periods of sitting and computer work. 8. Supply and support their own internet services. 9. Maintaining an uninterrupted internet connection is a requirement of all work from home position.

Benefits

- Comprehensive benefits package including medical, dental, and vision coverage. - Voluntary life insurance options for employee, spouse, and children. - Additional voluntary benefits: hospital indemnity, critical illness, accident indemnity, and pet insurance plans. - Basic life insurance, short-term disability, and long-term disability coverage at no cost. - Generous paid time off policy. - 401k plan with company match. - Apple equipment and a media stipend are provided for remote workspace.