Job Summary
A company is looking for a Senior Quality Analyst, Claims to manage a quality assurance program for compliance in a self-insured healthcare environment.
Key Responsibilities
- Ensure compliance with laws and regulations related to liability claims handling
- Develop and provide training and technical support for caregivers on relevant regulations
- Conduct internal audits and analyze claims data to identify improvement opportunities
Required Qualifications
- Bachelor's Degree in Business Administration, Public Health Administration, Organizational Leadership, Finance, or related discipline, or equivalent education and work experience
- 5 or more years of experience in healthcare professional liability and/or civil tort claims handling
- Experience reporting third-party liability settlements to CMS and regulatory agencies
- Experience in claims data analytics and quality assurance reviews
- Project management experience and developing policies and procedures
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