Medical Claims Quality Assurance Analyst - Remote

Overview

Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Medical Claims Quality Assurance Analyst, you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members.

In Short

• Perform audits on production, company guidelines, and system configurations to maintain quality standards.
• Conduct internal Prepay and Post-pay audits to identify discrepancies and ensure compliance.
• Work closely with external auditors to support their review processes.
• Identify and address quality issues, proposing solutions to enhance claims processing workflows.
• Strong working knowledge of Microsoft Office Suite.
• Proven expertise in claims processing and an understanding of related systems.
• Exceptional problem-solving and analytical skills.
• Ability to work independently and prioritize tasks in a high-pressure environment.
• Comprehensive benefits package after a waiting period.
• Join a team dedicated to providing high-quality, self-funded benefit plans.

Requirements

• Associate’s degree or 2+ years of relevant experience in quality assurance, auditing, or claims processing.
• Minimum 2 years of internal claims processing experience in a healthcare benefit or TPA environment.
• Strong organizational skills with the capacity to manage multiple assignments.
• Demonstrated customer service skills.
• Familiarity with auditing tools or software is preferred.
• Knowledge of healthcare regulations, including HIPAA.
• Experience with TPA operations is a plus.

Benefits

• Fantastic medical, dental, and vision insurance.
• Employer HSA contributions covering 50% of the HDHP plan’s annual deductible.
• Company provided Basic Life and AD&D.
• Company paid Short-Term and Long-Term Disability.
• 401(k) Retirement Plan with up to a 6% employer-match.
• 10+ paid holidays and generous paid vacation.
• Annual Volunteer Paid Day and Tuition Reimbursement.
• Annual Health and Wellness Reimbursement.
• Fun company events.