Claims Quality Coach in Morrisville, NC at Beacon Health Options

Date Posted: 2/24/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Claims Quality Coach to join our team at our office in Morrisville, NC.  The Claims Quality Coach is primarily responsible for reviewing and analyzing, as well as reporting, claims audit review and ensuring quality standards are met for department.

Position Responsibilities:

  • Performs quality review on a pre-determined percentage of claims per processor on a daily basis, including priority claims

  • Provides professional, accurate and timely feedback to claims processors to reduce errors and improve processes and performance

  • Mentors new claims processors and serves as subject matter expert

  • Reviews internal/client audit refutes on an as needed basis

  • Works with Training, Claims Supervisors and Manager to identify areas of improvement and ways to implement them within the claims team.

  • Collection and analysis of data elements related to systemic problems or processor error

  • Provides claims support when needed by reviewing, researching and investigating claims

  • Generates reports detailing quality findings and trend analysis

Position Requirements:

Education:  High school diploma or equivalent required.   

Licensure:  n/a

Relevant Work Experience:   Three (3) to five (5) years of relevant claims processing experience required. 

Knowledge, Skills & Abilities:

  • Strong computer skills required, including Word, Excel and Outlook

  • Prior experience with NASCO and Service Connect preferred

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.

EOE/AA/M/F/Veterans/Disabled

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