Claims Quality Assurance Supervisor
Benefits
3w PTO
Similar Jobs
See allMedical Management Quality & Training Manager
Partner Company
US
Quality Assurance
Training & Development
People Management
Director, Audits (Healthcare)
Health Services Advisory Group
US
Medicaid
HEDIS
Data Analysis
Director, Quality Operations
WelbeHealth
California
Quality Improvement
Regulatory Compliance
Data Analysis
Health Plan Quality Program Management & Performance Manager
Partner Company
US
HEDIS
Data Analysis
Project Management
Director, Premium Audit
Jobgether
US
Regulatory Compliance
Leadership
Budget Management
Core Responsibilities:
- Oversee auditing activities to ensure claims are paid accurately and timely per regulations.
- Identify operational gaps, develop solutions, and recommend improvements for processing and training.
- Track progress and communicate audit results to stakeholders regularly.
Qualifications:
- Minimum of five years experience in health plans, managed care, or PACE environment preferred.
- Working knowledge of Medicare and/or Medicaid billing and guidelines.
- Proven leadership, organizational, and communication skills with ability to mentor team members.
What We Offer:
- Medical, Dental, and Vision insurance coverage.
- 17 days PTO, 12 holidays, and 6 sick days annually.
- 401K savings with match and comprehensive compensation package including base pay and bonus.
WelbeHealth
WelbeHealth serves vulnerable seniors through shared intention, pioneering spirit, and the courage to love. It is a growing healthcare organization focused on team culture and mission.