Remote Quality Assurance Specialist- Non-IT
About The Position
This role will have the responsibility of quality testing all of the Pharmacy Benefit Plans. They will work in tandem with the AIS team as they build the plan. This person will then be working within a few systems to make sure the plan is built out correctly and to the specs of the client. If the plan is missing something or plan is built incorrectly they will then work with their counterpart in the AIS group to get it fixed. The most common issues they find are deductibles and out of pockets not being set up correctly, mail pricing being different etc. This role has a very high level of attention to detail, there is no phone work. They may communicate internally back and forth with their team / AIS reps but that will be it. They will have a scorecard once out of training. They will be expected to work 25 plans a week. This is a non-IT position falling under the operations vertical.
Requirements
- Two or Four year degree required
- Preference given to Math, Biology, business, healthcare admin, or History degrees. Anything with a large background in research for the degree
- 1 year of Excel experience (No V lookups or Pivot Tables)
- Quality assurance
- Data Entry
- QA
- Claims processing
- Microsoft office
- Excel
- Audit
- research
Nice To Haves
- 3+ years of health care insurance experience.
- Knowing medical terminology, deductible, copay, provider language will help them stand apart.
- Experience in a production based environment is a plus. They do run a scorecard, roughly 25 plans worked a week is the standard.
- Must have 1 year of excel experience and pass the test.
- Not looking for someone coming from call center or QA in call center.
Responsibilities
- Quality testing all of the Pharmacy Benefit Plans
- Work in tandem with the AIS team as they build the plan
- Work within a few systems to make sure the plan is built out correctly and to the specs of the client
- Work with their counterpart in the AIS group to get plan issues fixed
Benefits
- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
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What This Job Offers
Career Level
Mid Level
Number of Employees
501-1,000 employees
