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 conformity with the anticipated setup.

• Assist in test preparation, which includes the creation and validation of test data.

• Aid in maintaining testing timelines and achieving completion deadlines.

• Identify and document testing defects, inconsistencies, and observations.

• Monitor issues and facilitate escalation to Advisors or project leaders.

• Reassess fixes and confirm resolutions.

• Keep comprehensive documentation of testing results and findings.

• Adhere to established testing methodologies, quality controls, and documentation standards.

• Engage in lessons learned and contribute to enhancements in processes.

• Assist in updating testing documentation, job aids, and reference materials.

• Support pilot initiatives, special projects, and on-demand testing.

• Take part in project meetings, team discussions, and collaborative working sessions.

• Work in partnership with peers and cross-functional teams to ensure the success of testing deliverables.

• Enhance knowledge of benefits, configuration, and testing methodologies.

• Provide support across various Lines of Business, including HealthPlan, Medicare, Medicaid, Exchange, Commercial, DoD, and Cigna.

⛳️ Requirements

• A Bachelor's degree is required, along with a minimum of 1 year of experience in operations, benefits/clinical, claims processing, testing, quality assurance, audit, or a related field — 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 protocols, document findings, and adhere to deadlines.

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

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

• Strong attention to detail and a commitment to quality.

• Basic analytical and problem-solving capabilities.

• Ability to adhere to defined processes and deliver consistent, precise work.

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

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical insurance coverage.

• Vision insurance.

• Dental insurance.

• Access to well-being and behavioral health programs.

• 401(k) retirement plan.

• Company-paid life insurance.

• Tuition reimbursement opportunities.

• A minimum of 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence available.