Associate, Operations QA Auditor #924

Healthcare
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow.  We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds—tech people, numbers people, even people people—working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference—it’s time to make a healthy career move to MVP!
Full-Time, Non-Exempt

 

The MVP Operations Quality, Training and Documentation is looking for a new QA Auditor who will assist us with providing oversight to our Claims Processing team with the vision to help MVP be the difference for the customer.

Monitors and records the quality of work performed by units within the Operations Department for pre-payment of claims and claims audits, for all regions in all lines of business. Identify trends in specific errors and error rates. Determines and recommends needs for retraining, or clarification of work procedures. Develops and produces, periodic reports based on audits/projects completed, for the Quality Control Leadership. Shares this information within the Operations Department to drive for education and process enhancements. Research, identify and corrects deficiencies related to work quality, workflow or specific quality issues.


Performs other duties as assigned.

POSITION QUALIFICATION: Minimum Education: High School degree or equivalent. Two-year college degree or directly related business experience preferred.

Minimum Experience: One year of high-volume medical claims processing experience required. Proven track record of claims processing experience consistently exceeding quality requirements. New York State Independent Adjusters license, or the ability to obtain a NYS Independent Adjusters license.

Required Skills: • Excellent written and verbal communication skills; Proven organizational and analytic skills; Attention to detail and commitment to quality service required. Preferred Skills: • Working experience with PC spreadsheets and word processing preferred; Previous Quality Control experience preferred

About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal.  We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the EEO is the Law Poster and Supplement protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
 

Please apply and learn more – including how you may become a proud member of our team.

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