Quality Assurance Specialist
Company: VirtualVocations
Location: North Hollywood
Posted on: October 31, 2024
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Job Description:
A company is looking for a Quality Assurance Specialist-Appeals
& Grievance.
Key Responsibilities
Monitor and analyze Appeals and Grievances data to ensure
compliance with CMS guidelines
Produce quality performance reports and assist in departmental
audits
Identify training opportunities and potential improvements in
processes related to appeals and grievances
Required Qualifications
2+ years of healthcare appeals & grievances experience or related
QA experience
2+ years of managed healthcare experience
Bachelor's degree in healthcare, business, or a related field
preferred
Knowledge of Medicare Managed Care Plans required
Demonstrated knowledge of CMS Reporting (ODAG, Stars Measures,
etc.)
Keywords: VirtualVocations, Bell Gardens , Quality Assurance Specialist, Other , North Hollywood, California
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