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Claims Quality Assurance Specialist

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Job Overview

We are seeking a Claims Quality Assurance Specialist to join our team in the Light Industrial sector.

Key Responsibilities
  • Collaborate with various departments to ensure the system is prepared for testing scenarios.
  • Ensure the accuracy and reliability of claims data within the EyeMed claims and payments User Acceptance Testing (UAT) systems.
  • Monitor all testing issues and track the progress of their resolution through re-evaluation.
  • Evaluate and document clear and concise testing outcomes to facilitate a seamless transition to EyeMed claims and payments production systems.
  • Maintain consistent and effective communication within the Claims Testing Team and other essential departments.
Qualifications
  • Proven experience in Claims or Data processing/testing.
  • Intermediate proficiency in computer systems and spreadsheet software.
  • Familiarity with Claims Adjudication, Payments/Billing, and Data Reporting systems.
  • Excellent communication, problem-solving, teamwork, and organizational skills.
  • Strong analytical abilities and critical thinking.
  • Capability to work collaboratively across functions.
  • Ability to manage multiple tasks and project timelines effectively.
  • Knowledge of Oracle SQL and/or Business Objects/EDW.
  • Familiarity with Facets and SAP.
  • Self-motivated and proactive individual.