Provider Network Audit Quality Analyst

Description: • Acts as an Advocate for, and support, the business by serving as a quality champion • Performs routine quality audits for network operations and claim testing • Conduct standard quality reviews /audits to measure compliance with published policies • Identify and distribute errors to business partners • Support the design and development of new processes • Analyze and resolve complex claims scenarios within established time frames • Respond to and resolves customer inquiries and complaints (internal as well as external) • Analyzes and recommends solutions to non-standard requests and requirements from plan sponsors. Requirements: • 1-2+ years work experience in the audit environment that reflects a proven track record or proficiency in the competencies noted. • Experience with claims testing, and a working knowledge of PPO’s. • Experience with DG system. Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access • Many other benefits depending on eligibility. Apply Job!