Quality Assurance Specialist - Remote

Overview

The NEMT Quality Assurance Specialist is responsible for handling grievances related to non-emergent medical transportation, ensuring optimal resolution through collaboration with members, providers, and internal departments.

In Short

• Full-time remote position based in Oregon.
• Handles verbal and written grievances from members and providers.
• Collaborates with internal departments for grievance resolution.
• Responsible for EDI processes for claims submission.
• Maintains relationships with community partners and agencies.
• Generates and tracks grievance reports.
• Investigates grievances and communicates with members.
• Coordinates with billing specialists on claims issues.
• Submits quarterly and monthly quality assurance reports.
• Performs additional duties as assigned.

Requirements

• Three years of experience in healthcare or related fields.
• Understanding of NEMT contract requirements.
• Excellent verbal and written communication skills.
• Flexible and able to multi-task in changing situations.
• Effective listening and problem-solving skills.
• Handles sensitive information confidentially.
• Proficient in MS software and Google Suites.
• Strong attention to detail and organizational skills.
• Education: High school diploma required; Bachelor's preferred.

Benefits

• Competitive salary of $60,000 - $65,000 DOE.
• Medical, dental, and vision insurance for employees and dependents.
• 22 paid time off days and 12 paid holidays.
• 401k contribution with employer contributions.
• Cell phone and internet reimbursements.
• Wellness benefits offered.
• Additional compensation for bilingual skills in Spanish.
• EAP and FSA with employer contributions.
• Mileage reimbursement available.
• Triple AAA insurance provided.