Quality Review and Audit Lead Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Carry out designated testing tasks for implementations, benefit modifications, and business projects in accordance with established test plans and procedures.

• Conduct data validation and execute test cases to ensure accuracy, completeness, and alignment with expected setups.

• Aid in the creation and validation of test data.

• Support testing timelines and ensure completion dates are met.

• Identify, document, track, and escalate any testing defects, discrepancies, and observations.

• Perform retesting of fixes and validate the effectiveness of resolutions.

• Keep comprehensive documentation of testing results and findings.

• Adhere to testing processes, quality control measures, and documentation standards.

• Engage in lessons learned sessions and initiatives for process improvement.

• Revise testing documentation, job aids, and reference materials as needed.

• Contribute to pilot projects, special initiatives, and ad hoc testing activities.

• Attend project meetings, team discussions, and collaborative working sessions.

• Work together with colleagues and cross-functional teams to ensure testing deliverables are met.

• Enhance understanding of benefits, configuration, testing methods, business processes, and various Lines of Business.

• Take part in client-facing tasks with appropriate supervision.

⛳️ Requirements

• A Bachelor’s degree is required, along with 1+ years of experience in operations, benefits/clinical, claims processing, testing, quality assurance, audit, or a related field preferred – or – at least 5+ years of relevant experience.

• Basic understanding of healthcare benefits and/or claims processing is preferred.

• A background in clinical, pharmacy, or healthcare-related fields is preferred.

• Capability to follow testing instructions, document results, and adhere to deadlines.

• Eagerness to learn about HealthPlan, Medicare, Medicaid, Exchange, Commercial, DoD, and Cigna Lines of Business.

• Proficient in Microsoft Excel, Word, Outlook, PowerPoint, and SharePoint.

• Strong attention to detail and a quality-focused approach.

• Essential analytical and problem-solving abilities.

• Ability to follow established processes and deliver consistent, accurate work.

• For remote work, a cable broadband or fiber optic internet connection with a minimum of 10Mbps download and 5Mbps upload speed is required.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical insurance coverage.

• Vision insurance plans.

• Dental insurance options.

• Access to well-being and behavioral health programs.

• 401(k) retirement plan.

• Company-funded life insurance.

• Tuition reimbursement opportunities.

• A minimum of 18 days of paid time off each year.

• Paid holidays.

• Leaves of absence available.

• Requirement for home-based work includes cable broadband or fiber optic internet service with minimum speeds of 10Mbps download and 5Mbps upload.