Claims Quality Assurance Specialist

2 weeks ago

Elkridge, Maryland, United States Conduent Full time
Job Summary

We are seeking a highly skilled Claims Quality Assurance Analyst to join our team at Conduent. As a Claims Quality Assurance Analyst, you will play a critical role in ensuring the quality and integrity of our claims processing systems.

Key Responsibilities
  • Monitoring and Auditing: Monitor and audit access to all internal systems to ensure compliance with company policies and procedures.
  • Claims Audits: Conduct audits related to claims, systems, business, and project requirement rules to identify areas for improvement.
  • Project Monitoring: Monitor projects for defects or potential errors and take corrective action as needed.
  • RCA and CAP Management: Manage Root Cause Analysis (RCA) and Corrective Action Plans (CAP) for the project during audits.
  • Policies and Procedures: Ensure that documented policies, procedures, and workflows are maintained and up-to-date.
  • Data Quality and Analysis: Utilize experience with data warehouse to enhance data quality and analysis.
  • Outreach and Education: Perform outreach and education sessions for Maryland Medicaid Providers.
Requirements
  • Education: Possess a bachelor's degree in information technology, Computer Science, or a related field.
  • Experience: Have a minimum of 3 years of experience in IT Quality Assurance or a related role.
  • Skills: Show strong knowledge of Change and Release Management processes, possess experience with data warehouse and its applications, and demonstrate proficiency with MS Office Suite.
  • Personal Qualities: Have excellent analytical and problem-solving skills, exhibit strong communication and interpersonal skills, and be able to travel and attend in-person state meetings as required.
Benefits
  • Flexible Working: Enjoy the convenience of working from home and maximize your time by unplugging at the end of your workday.
  • Perks and Rewards: Receive health and welfare benefits, retirement savings, employee discounts, career growth opportunities, paid training, and paid time off.
About Conduent

We are a global company with a mission to create exceptional outcomes for our clients and the millions of people who count on them. We strive to create a culture where you can bring your authentic self to work, grow and thrive, both personally and professionally, and make a difference with our clients, in our communities, and with the millions of people we support.

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