Quality Assurance Specialist III (Remote)

CareFirst•Baltimore, MD

19h•Remote

About The Position

The Quality Assurance Specialist III is an advanced-level auditor position performing in-depth system and procedural audits. This role conducts regular reviews and audits of internal controls within each functional area for strengths and weaknesses ensuring special focus to the specific risk areas. The incumbent is considered a Subject Matter Expert (SME) in their audit field and provides a comprehensive analysis of transaction, systems and procedures.

Requirements

High School Diploma or GED.
5 years Auditing, Quality Assurance, Operations, Training, Project Management or comparable work experience.
2 years experience as Quality Assurance Specialist II.
Knowledge of quality assurance and production technologies.
Proficient in Microsoft Office programs.
Extensive of industry standards, quality control techniques and procedures.
Excellent communication skills both written and verbal.
Extensive analytical and problem solving skills.
Strong interpersonal skills.
Excellent research and organizational skills.
Must be eligible to work in the U.S. without Sponsorship.

Nice To Haves

G6 claims
ECA Certified Quality Assurance Manager Preferred

Responsibilities

Audits assigned function (claims) for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures.
Identifies, documents and reports transaction errors utilizing departmental quality monitoring templates in a timely manner to ensure prompt resolution.
Assists in development of special department projects and participates in department and divisional projects.
Conducts structured coaching and feedback sessions.
Provides suggestions and creates improvement plans for areas of deficiency within the group or for an individual.
Participates in the creation and implementation of new methods, processes and/or products.