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WellSense Health Plan

Boston, Massachusetts

B.E. Smith in partner with Samaritan Healthcare Logo
B.E. Smith in partner with Samaritan Healthcare

Moses Lake, Washington

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Beth Israel Deaconess Hospital - Plymouth

Plymouth, Massachusetts

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AdventHealth

Orlando, Florida

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University of Maryland Medical System

Easton, Maryland

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Northeast Georgia Health System

Gainesville, Georgia

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Duke University Health System

Durham, North Carolina

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Veterans Affairs, Veterans Health Administration

North Chicago, Illinois, Illinois

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Veterans Affairs, Veterans Health Administration

Walla Walla, Washington, Washington

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Duke University Health System

Durham, North Carolina

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Veterans Affairs, Veterans Health Administration

Columbia, South Carolina, South Carolina

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AdventHealth

Altamonte Springs, Florida

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Rush University Medical Center

Chicago, Illinois

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Foundation Health Partners

Fairbanks, Alaska

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AdventHealth

Altamonte Springs, Florida

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University of Maryland Medical System

Glen Burnie, Maryland

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Kindred Hospitals

La Mirada, California

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Fred Hutchinson Cancer Center

Seattle, Washington

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Sr Claims Quality Assurance Analyst
JOB SUMMARYTo review claims for new hires, experienced Examiners and auto adjudicated claims in a timely and consistent manner. Generate accuracy reports per processor to be reviewed by operations management and senior management staff. Senior Claims Quality Assurance Analyst will be responsible for trending and root cause analysis and providing a clear and concise report to the management staff. Senior Claims Quality Analyst will be responsible for reviewing and responding to all first level appeals. Senior Claims Quality Analyst responsibility will include mentoring Examiners and Quality Analyst as requested. Responsibilities also include the review and audit of the Provider Communication, Provider Fee


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