REMOTE Healthcare - Claims Quality Assurance Associate

Job description

About Conduent:
Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them.

You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

Job Description:
*Conduent is hiring REMOTE Healthcare- Claims Quality Assurance Associates*

We need a select few upbeat, articulate, computer/tech savvy, and reliable Claims Quality Assurance Associates to join our Team. You will conduct audits on the entire Life Cycle of Medical Claims:

Data Entry

Provider Add

Prepay

Post Pay

Adjustments/Corrected Claims

PDRs

Training: Will mirror work schedule

Work Hours - Flexible

Pay: $19/hourly - $20/hourly

Full Time - regular position [40 hours - overtime when needed by client]

Equipment provided

This a Remote / WFH position

Experience:

Medicaid / Medicare Claim Processing Experience

Hard Skills:

Microsoft Office 365

Excel (Proficient)

Microsoft Teams

SharePoint

Access Database

Soft Skills:

Quick Study

Positive

Excellent Communication and Documentation

Attention to detail

Organized

Requirements:

Must be at least 18 years of age with at least a high school diploma or GED.

Must pass a criminal background check.

Must have WIRED internet connection, WIFI is not permitted.

Plus:

Bilingual [Spanish / English]

Job Track Description:

Performs business support or technical work, using data organizing and coordination skills.

Performs tasks based on established procedures.

In some areas, requires vocational training, certifications, licensures, or equivalent experience.

General Profile

Expands skills within an analytical or operational process.

Maintains appropriate licenses, training, and certifications.

Applies experience and skills to complete assigned work.

Works within established procedures and practices.

Establishes the appropriate approach for new assignments.

Works with a limited degree of supervision.

Functional Knowledge

Has developed skillset in a range of processes, procedures, and systems.

Business Expertise

Helps teams to integrate and work together to support the achievement of company goals.

Impact

Impacts a team, by example, through the quality service and information provided.

Uses discretion to modify work practices and processes to achieve results or improve efficiency.

Leadership

May provide informal guidance to junior team members.

Problem Solving

Ability to problem solve, self-guided.

Evaluates issues and solutions to provide the best outcome for clients and end-users.

Interpersonal Skills

Clearly and effectively exchanges information and ideas.

Responsibility Statements

Creates a quality checklist to determine potential defects.

Reviews transactions and selects samples for auditing.

Performs risk assessments related to performance monitoring and financial operations.

Understands the connectivity of up-stream and down-stream processes with respect to the process they are auditing.

Validates audit findings with operations personnel to concur with root cause analysis (RCA).

Performs other duties as assigned.

Complies with all policies and standards.

Closing:
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: . You may also .