Quality Assurance Specialist

1 week ago

Seattle, Washington, United States CareOregon Full time
Job Title: Quality Assurance Specialist

CareOregon is seeking a highly skilled Quality Assurance Specialist to join our team. As a Quality Assurance Specialist, you will play a critical role in ensuring the quality and integrity of our operations.

Key Responsibilities:
  • Perform routine and complex audits to identify exceptions to established internal processes and regulatory or contractual requirements.
  • Assist in identifying ways to improve quality and productivity, and minimize rework.
  • Support fraud and abuse audits, and perform first-level audits based on reports.
  • Research claim, enrollment, and clinical operations processing problems and errors to determine their origin and appropriate resolution.
  • Develop and provide summary-level reports and individual staff quality reports to leadership.
  • Support leaders in external and internal audits, including data validation for preparation of audit universes.
  • Analyze data processing reports and make necessary corrections or adjustments.
  • Participate in training and processing activities to stay up-to-date on processing procedures.
  • Assist with training of staff as needed.
Requirements:
  • Strong analytical and problem-solving skills.
  • Ability to work independently and collaboratively as part of a team.
  • Excellent communication and interpersonal skills.
  • Ability to maintain confidentiality and handle sensitive information.
  • Strong attention to detail and organizational skills.
What We Offer:
  • A competitive salary range of $57,560 - $70,360/year, with a 5% bonus target.
  • A comprehensive benefits package, including medical, dental, and vision insurance.
  • A 401(k) retirement plan with a company match.
  • Opportunities for professional growth and development.

CareOregon is an equal opportunity employer and welcomes applications from diverse candidates. If you are a motivated and detail-oriented individual who is passionate about quality and excellence, we encourage you to apply for this exciting opportunity.

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