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Associate, Operations QA Auditor

Headquarters Office, Schenectady, New York, United States of America, Rochester Office, Rochester, New York, United States of America, Tarrytown Office, Tarrytown, New York, United States of America Req #228
Friday, August 2, 2019
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.


Summary:
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. Presents these reports, as needed to specific leadership members within the Operations Department. 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 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:
Good 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

MVP Health Care is an Affirmative Action/Equal Opportunity Employer (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), 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.

Other details

  • Job Family Claims/Operations
  • Pay Type Hourly
  • Headquarters Office, Schenectady, New York, United States of America
  • Rochester Office, Rochester, New York, United States of America
  • Tarrytown Office, Tarrytown, New York, United States of America