Senior Quality Analyst, Claims

Job Summary

A company is looking for a Senior Quality Analyst, Claims to manage a quality assurance program for liability claims.

Key Responsibilities

• Ensure compliance with laws and regulations governing liability claims handling
• Develop training and provide technical support regarding Medicare Secondary Payer reporting and related regulations
• Facilitate internal audits and provide quality assurance recommendations based on data analysis

Required Qualifications

• Bachelor's Degree in Business Administration, Public Health Administration, Organizational Leadership, Finance, or a related discipline, or equivalent education and work experience
• 5 or more years of experience handling healthcare professional liability and/or civil tort claims
• 5 or more years of experience in reporting third-party liability settlements to CMS and regulatory agencies
• Experience reviewing claims files for quality assurance purposes
• Experience in project management and developing policies and procedures