Claims Quality Assurance Specialist

3 days ago


Elkridge, Maryland, United States Conduent Full time
Claims Quality Assurance Analyst

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

Responsibilities:
  • Monitor and audit access to all internal systems to ensure compliance with company policies and procedures.
  • Conduct audits related to claims, systems, business, and project requirement rules to identify areas for improvement.
  • Monitor projects for defects or potential errors and manage RCA and CAP for the project during audits.
  • Ensure that documented policies, procedures, and workflows are maintained and up-to-date.
  • Utilize experience with data warehouse to enhance data quality and analysis.
  • Perform outreach and education sessions for Maryland Medicaid Providers to ensure compliance with regulations.
Qualifications:
  • Possess a bachelor's degree in information technology, Computer Science, or a related field.
  • Have a minimum of 3 years of experience in IT Quality Assurance or a related role.
  • Show strong knowledge of Change and Release Management processes.
  • Possess experience with data warehouse and its applications.
  • Demonstrate proficiency with MS Office Suite.
  • Have excellent analytical and problem-solving skills.
  • Exhibit strong communication and interpersonal skills.
  • Show experience with PBM (Pharmacy Benefit Management), Medicaid, and Medicare desired.
  • Able to travel and attend in-person state meetings as required.
What We Offer:
  • A competitive salary range of $70-85k per year.
  • A comprehensive benefits package, including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation or sick time.
  • A flexible working environment, including remote work options.
  • Opportunities for career growth and professional development.

At Conduent, we value diversity, equity, and inclusion. We strive to create a culture where everyone feels welcome and valued. If you are a motivated and detail-oriented individual who is passionate about quality assurance, we encourage you to apply for this exciting opportunity.



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