Senior Quality Analyst, Claims

Job Summary

A company is looking for a Senior Quality Analyst, Claims to manage a quality assurance program for compliance in a fast-paced claims environment.

Key Responsibilities

• Ensure compliance with laws and regulations related to liability claims handling
• Develop and provide training and technical support for caregivers regarding Medicare Secondary Payer reporting and related regulations
• Conduct internal audits and provide quality assurance recommendations based on data analysis and organizational metrics

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 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