Quality Assurance Analyst | Prior Authorization

IVX Health

12h•$26 - $30•Remote

About The Position

IVX Health is seeking a Quality Assurance Analyst to safeguard the quality, compliance, and performance of our Intake and Prior Authorization workflows. This role plays a critical part in reducing denial risk, strengthening documentation accuracy, and improving SLA performance through structured case audits and data-driven process improvement. If you have strong prior authorization experience and enjoy identifying trends, mitigating risk, and driving operational improvement, this role offers meaningful impact within a growing healthcare organization.

Requirements

High School Diploma or GED required; Associate degree in a healthcare-related field (Medical Office Management, Medical Insurance, Medical Coding, or related) strongly preferred
Minimum 3+ years of experience in prior authorization, benefits investigation, or revenue cycle operations
Experience conducting documentation audits or quality assurance reviews in a healthcare environment
Demonstrated knowledge of medical necessity review standards, prior authorization workflows, payer policies, and benefits investigation best practices
Experience utilizing Excel for data tracking and analysis, as well as audit management or reporting platforms required
Strong analytical thinking, attention to detail, and organizational skills
Clear written and verbal communication skills
Working knowledge of HIPAA and healthcare compliance standards
Experience with EHR, practice management, or revenue cycle systems

Responsibilities

Conduct structured audits of Intake and Prior Authorization cases
Evaluate documentation accuracy, medical necessity support, and adherence to internal SOPs and payer policies
Maintain defensible audit documentation and compliance standards
Monitor SLA performance, denial trends, and recurring workflow errors
Develop recurring QA reports with actionable insights
Identify systemic process vulnerabilities and training gaps
Document findings clearly and administer QA result notifications
Partner with Operations leadership on corrective action plans
Recommend workflow and SOP updates based on audit findings
Support readiness for internal audits and compliance reviews

Benefits

Comprehensive Healthcare – Medical, dental, and vision coverage, including prescription drug plans and telemedicine services.
Flexible Savings Options – Choose from Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA) to manage healthcare costs.
Supplemental Protection – Accident, critical illness, and hospital indemnity plans to provide additional financial security.
Dependent Care FSA – Pre-tax savings for eligible childcare and dependent care expenses.
401(k) Retirement Plan – Secure your future with a competitive company match.
Disability Coverage – Voluntary short-term and long-term disability plans to protect your income.
Fertility and Family Support – Resources and benefits designed to support fertility care and family planning.
Life and AD&D Insurance – Financial protection for you and your loved ones.
Counseling and Wellness Support – Free resources to support emotional, physical, and financial well-being.
Education Assistance – Tuition reimbursement and certification support to help you grow in your career.
Continuing Education – Access to a CEU library for ongoing professional development.
Charitable Giving and Volunteer Program – Matched donations and paid volunteer time off to support causes you care about.
Employee Referral Bonus – Earn rewards for helping us find top talent.