Quality Assurance Specialist

Company: VirtualVocations
Location: North Hollywood
Posted on: October 31, 2024

Job Description:

A company is looking for a Quality Assurance Specialist-Appeals & Grievance.

Key Responsibilities

Monitor and analyze Appeals and Grievances data to ensure compliance with CMS guidelines
Produce quality performance reports and assist in departmental audits
Identify training opportunities and potential improvements in processes related to appeals and grievances

Required Qualifications

2+ years of healthcare appeals & grievances experience or related QA experience
2+ years of managed healthcare experience
Bachelor's degree in healthcare, business, or a related field preferred
Knowledge of Medicare Managed Care Plans required
Demonstrated knowledge of CMS Reporting (ODAG, Stars Measures, etc.)

Keywords: VirtualVocations, Gardena , Quality Assurance Specialist, Other , North Hollywood, California

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