Come join our team at MultiPlan! Founded in 1980, we are the industry's most comprehensive provider of healthcare cost management solutions. We have almost 900,000 healthcare providers under contract, an estimated 68 million consumers accessing our network products, and 40 million claims reduced through our network and non-network solutions each year.
JOB SUMMARY: To perform daily audits of work performed in assigned operational areas to ensure work adheres to processes as defined by each specific area and meets or excees the set quality standard. To deliver audit results in a timely and consistent manner, meeting all department quality and production goals ane remaining current with all applicable business and audit processes.
JOB ROLES AND RESPONSIBILITIES:
1. Perform daily audits and follow standard processes and procedures for assigned positions.
2. Identify recurring issues for review and recommendations.
3. Display basic understanding of standard review processes and work flows, providing consistency and appropriate detail in alignment with all policies and procedures, business rules and overall department guidelines.
4. Maintain consistent quality and production standards with consideration around specific audit and turnaround time expectations.
5. Collaborate, coordinate, and communicate across disciplines and departments.
6. Ensure compliance with HIPAA regulations and requirements.
7. Demonstrate Company's Core Competencies and values held within.
8. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
This job works under general supervision to complete job responsibilities. The incumbent possesses and applies a range of knowledge gained through experience to complete the job responsibilities. One uses established guidelines and experience to resolve issues and refers more complex issues to higher levels.
* Minimum HS Diploma (or GED)
* Minimum 1 year related industry experience
* Quality assurance experience preferred
* Required licensures, professional certifications, and/or Board certifications as applicable
* Knowledge of claim payment and process preferred
* Knowledge of insurance or healthcare industry
* Knowledge of methodology for multiple position in order to identify issues.
* Communication (written, verbal and listening), attention to detail, interpersonal and analytic skills
* Ability to maintain consistent quality and production standards
* Ability to be detail oriented
* Ability to use software, hardware and peripherals related to job responsibilities including MS Office Suites, Word, Excel, Outlook, etc.
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
As a QA Auditor with MultiPlan, you will be part of an organization with a proud 30-year legacy of experience and growth. We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
* Medical, dental, and vision coverage
* Life insurance
* Optional and dependent life insurance
* Short- and long-term disability
* 401(k) employer matching
* Paid time off (earn 20 days per year)
* Paid company holidays
* Floating holiday
* Tuition reimbursement
* Flexible Spending Account
* Employee Assistance Program
Summer hours = Memorial Day to Labor day we get off two hours early EVERY FRIDAY!!
Opportunity. Recognition. Satisfaction. Grow your career with MultiPlan!
As an Equal Opportunity Employer, the Company will provide equal consideration to all employees and job candidates without regard to sex, age, race, marital status, sexual orientation, religion, national origin, citizenship status, physical or mental disability, political affiliation, service in the Armed Forces of the United States, or any other characteristic protected by federal, state, or local law.
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Website : http://www.multiplan.com
MultiPlan is committed to helping healthcare payers and providers manage the cost of care, improve their competitiveness and inspire positive change. Leveraging sophisticated technology, data analytics and a team rich with industry experience, the company interprets clients’ needs and customizes innovative solutions that combine its payment integrity, network-based and analytics-based services. MultiPlan is a trusted partner to 700 healthcare payers in the commercial health, property and casualty, and government markets.