Quality Assurance Analyst I

As a Quality Assurance Advisor I, you will be responsible for ensuring the quality of claims processing through the implementation and management of quality assurance processes and procedures. You will analyze claims data and identify emerging patterns and gaps in existing processes to improve the overall claims process. A Reserv QA Analyst is someone who understands that the QA process isn’t meant to be punitive, but rather is an opportunity for development and process improvement. This position requires someone who is detail-oriented, analytical, and operationally-minded to ensure that the company delivers the highest level of quality and service to its clients. We need you to conduct audits and reviews of claims to ensure compliance with industry regulations, company policies, and procedures, verifying that payments were made correctly and in accordance with appropriate plans and policies. You will also analyze claims data to identify trends, patterns, and opportunities for improvement; communicate findings to Claims stakeholders and identify opportunities to increase use of data in identifying trends. Additionally, you will assist with developing training materials, documentation, quick reference guides and help to facilitate training sessions with the claims team and stay up-to-date on industry trends, regulations, and best practices related to claims quality assurance.