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Claims Quality Assurance Manager

1 month ago

Scottsdale, United States Renaissance Personnel Group Full time
Job DescriptionJob DescriptionJoin a global leader in the insurance world as a Claims Quality Assurance Manager and take charge of maintaining and elevating the organization's standards. This pivotal role oversees the Claims Department's quality assessment program, shaping and implementing measures that drive excellence and efficiency for their customers. Reporting directly to the Senior Director of Claims, you will play a crucial role in optimizing departmental performance for a small, but growing team, and the clients you serve.

Key Responsibilities:
  • Supervise the operations and performance of roles including Aggregate Specialist, Closing Specialist, and Claims Reporting Analysts.
  • Develop and implement comprehensive quality measures across the department.
  • Manage all audit programs, ensuring adherence to standards like the Dollar Limit Release audit.
  • Ensure accuracy and timeliness in closing activities performed by Closing Specialists.
  • Implement audit controls for Reporting Specialists to maintain consistency in monthly reporting.
  • Generate monthly aggregate activities reports from Aggregate Specialists.
  • Collaborate closely with Claims Management to enhance service delivery.
  • Cultivate positive relationships with internal teams and external clients.
  • Contribute to the development and execution of efficient Claims operations policies and procedures.
  • Assist in designing and implementing training programs to uphold quality standards.
  • Undertake additional duties and projects as assigned.
Qualifications:
  • 3-5 years of progressive Quality Assurance experience, with knowledge of Six Sigma Quality Control principles.
  • Experience within a Medical Claims production environment is required.
  • Bachelor's degree in a related field or equivalent work experience in Stop Loss, Ancillary, or TPA environments (preferred).
  • 3-5 years of people management experience is required.
  • Proficiency in Microsoft Office Suite, especially in Excel
  • Strong organizational skills with the ability to manage time effectively and meet deadlines.
  • Excellent written and verbal communication skills.
  • Strong teamwork and collaboration abilities.
  • Detail-oriented with a sense of urgency.
Why Join the Team?:
  • Flexibility: Enjoy the benefits of a hybrid work environment with flexible scheduling options.
  • Comprehensive Benefits: Access a competitive benefits package from day one, including generous Paid Time Off (PTO) and paid holidays.
  • Continual Learning: Thrive in a collaborative, education-focused work environment.
  • Annual Bonus Program: Earn rewards through our bonus program after just one year of employment.
If you're passionate about quality assurance and driving organizational growth, we invite you to apply for this exciting opportunity.

Position Details: This is an hybrid position offering the flexibility to work remotely up to 2 days a week after training. First 60 days of training is fully onsite, 5 days per week. Please note, in-office presence may be required more frequently initially to support key activities such as hiring, training, and business operations.

$60-80K DOE
Scottsdale, AZ
Full benefits

#ZRCompany DescriptionRenaissance connects skilled employees with businesses in the Greater Phoenix Metropolitan Area. Recruiting for administrative, professional, and executive management roles for both temporary placement and direct hire.

Founded in 1994, Renaissance is woman owned (WBE and WOSB certified) and experienced in a broad range of professional disciplines. With highly tenured recruiters and two generations of family owners working in the business, our success in placing people who stay and contribute to your business success is no surprise.

Renaissance is recognized for its 94 percent placement retention rate. That, along with over 100 Five-Star Google Reviews, best tell the story of what Renaissance can do for you.

As a locally owned boutique professional services firm, we are unlike any other professional search firm or temp agency. We understand the intricacies of Metropolitan Phoenix, its’ labor market and geography and have grown as the region has grown. We help both entrepreneurial and enterprise businesses achieve their goals by employing the people uniquely suited to their needs.Company DescriptionRenaissance connects skilled employees with businesses in the Greater Phoenix Metropolitan Area. Recruiting for administrative, professional, and executive management roles for both temporary placement and direct hire.\r
\r
Founded in 1994, Renaissance is woman owned (WBE and WOSB certified) and experienced in a broad range of professional disciplines. With highly tenured recruiters and two generations of family owners working in the business, our success in placing people who stay and contribute to your business success is no surprise.\r
\r
Renaissance is recognized for its 94 percent placement retention rate. That, along with over 100 Five-Star Google Reviews, best tell the story of what Renaissance can do for you.\r
\r
As a locally owned boutique professional services firm, we are unlike any other professional search firm or temp agency. We understand the intricacies of Metropolitan Phoenix, its’ labor market and geography and have grown as the region has grown. We help both entrepreneurial and enterprise businesses achieve their goals by employing the people uniquely suited to their needs.