Performance Quality Analyst I - CareBridge
Elevance Health•Nashville, TN
•Onsite
About The Position
The Performance Quality Analyst I is responsible for driving service quality excellence by evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.
Requirements
- Requires a BS/BA; 2+ years related experience in an enrollment and billing, claims and/or customer contact automated environment; or any combination of education and experience, which would provide an equivalent background.
Responsibilities
- Assists higher level auditor/lead on field work as assigned, including performing special audits and targeted audits as requested by internal management.
- Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment & billing transactions and the corrective action plan process.
- Analyzes and interprets data and makes recommendations for change based on judgment and experience, applies audit policy, and assesses risks to minimize our exposure and mitigate those risks.
- Documents audit results, documents findings, and suggests appropriate remediation.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
