Quality Assurance Specialist I - Owings Mills, United States - CareFirst BlueCross BlueShield

CareFirst BlueCross BlueShield
CareFirst BlueCross BlueShield
Verified Company
Owings Mills, United States

3 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

Resp & Qualifications

PURPOSE:


The Specialist, Quality Assurance I is responsible for examining and evaluating the accuracy of transactions in accordance with regulations and company guidelines.

Fairly and consistently reviews team interactions with both internal and external parties to ensure accuracy and support success in executing superior service and quality.


ESSENTIAL FUNCTIONS:

Audits assigned function (claims) 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. -
QUALIFICATIONS:
Education Level:
High School Diploma or GED.


Experience: 2 years progressive claims/customer service/enrollment &/or billing auditing experience, preferably in healthcare or insurance sector.


Preferred Qualifications:
Facets Claims processing**.


Knowledge, Skills and Abilities (KSAs)

  • Basic knowledge of quality assurance and production technologies.
  • Proficient in Microsoft Office programs.
  • Basic knowledge of industry standards, quality control techniques and procedures.
  • Excellent communication skills both written and verbal.
  • Excellent Research and organizational skills.
  • Excellent decision making and interpersonal skills.

Salary Range:
$41,472 - $76,032


Salary Range Disclaimer

Department

FEHBP OPM HMO

Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.

It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.


Where To Apply

Federal Disc/Physical Demand

Note:

The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.


PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.


Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship.

LI-TJ1
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