AmeriHealth Caritas Keyword Location Search view all jobs Operations Quality Auditor, Call Center Virtual, USA Posted 3 days ago

Apply Now Role Overview:

Under the direct supervision of the Supervisor, Manager, and/or Director of Operations Quality Auditing, the Operations Quality Auditor is responsible for the timely and accurate review of various tasks performed by Operations (including, but not limited to, Call Center).

Work Arrangement:

Hybrid- Associate must be in the office at least three (3) days per week, including core days of Tuesdays and Wednesdays. For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Responsibilities:

Identifies system and/or operational issues hindering the attainment of quality performance standards as defined by AMFC policy and associated business rules. Provides issue identification, problem analysis, and strategies for resolution and/or implementation to Management. Accurately documents audit findings in the appropriate quality tool.

Education and Experience:

High School/GED required. Minimum 3 years' claims experience in a Medicaid environment. Claims processing knowledge required, preferably with the Facets system. Working knowledge of Microsoft Office applications. Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you. Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI. Apply Now Active Filters Operations Quality Aud... Virtual, USA Clear All Powered By Cookie Policy We use cookies to improve your experience on our site. To find out more, read our privacy policy Accept Cookies Decline Cookies