QA Ops Auditor - Bilingual English/Spanish - Remote

Overview

The Quality Assurance Operations Auditor is responsible for performing Internal Quality Assurance Audits of non-financial Operational processes for internal employees, assisting with interpreting Clinical Care Manager call handling, and outsourced vendors to ensure compliance with policies, procedures, and quality standards.

In Short

• Perform Internal Quality Assurance Audits of operational processes.
• Investigate and conduct root cause analysis.
• Prepare written audit reports and communicate findings.
• Ensure compliance with policies, procedures, and quality standards.
• Identify patterns and trends related to audited performance.
• Conduct compliance audits for member/provider accounts.
• Assist in the development of departmental policies and procedures.
• Comply with HIPAA guidelines.
• Handle increasing workload and responsibility.
• Work with Microsoft Office applications.

Requirements

• Healthcare operations experience in Quality Assurance.
• Experience with Microsoft Office suite.
• Strong written and verbal communication skills.
• High School Diploma or GED required.
• Experience handling Personal Health Information (PHI).
• Experience in an Auditing capacity preferred.
• Ability to learn and evaluate new information.
• Knowledge of lines of business such as Medicare or Medicaid.
• Associate degree or higher preferred.
• Willingness to handle increasing workload.

Benefits

• Medical, dental, and vision coverage.
• Incentive and recognition programs.
• Life insurance.
• 401k contributions.
• Competitive compensation package.
• Full range of benefits subject to eligibility requirements.
• Opportunity to make a difference in people's lives.
• Access to high-quality, affordable healthcare.
• Supportive work environment.
• Commitment to employee growth and development.