Quality Assurance Auditor

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    "jobTitle": "Quality Assurance Auditor",
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    "description": "<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">POSITION SUMMARY</span></span></b></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">The Quality Assurance Auditor will be responsible for the completion of multiple audit tasks including but not limited to auditing the building of plan coders as needed for all new and existing revisions, along with compiling and reporting results and trends accurately.  The QA Auditor is also responsible for auditing outgoing correspondence from the Medical Review, Appeals, and Refund teams, as well as complete audit of claim adjustments by the Rapid Response team.  The QA Auditor will interpret the benefits in the plan documents to determine how benefits are payable and tracked/reported in the QicLink system.</span></span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">ESSENTIAL FUNCTIONS </span></span></b></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Log and track data to be audited</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Audit outgoing correspondence from the Medical Review, Appeals, and Refund teams</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Conduct complete audit of claim adjustments by the Rapid Response team</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Communicate and coordinate with other departments involved in the audit process</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Audit new and existing plans built by plan coders for all new and existing revisions</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Assist with current audit programs in place as well as identifying ways to improve audit results</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Track and report audit trends and communicate training requirements to Management based on audit results</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Monitor and track audit progress to ensure all audit tasks are complete by the determined deadline</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Audit data for accuracy as well as workflow compliance</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Other duties as assigned</span></span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">EDUCATION</span></span></b></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Bachelor's degree or equivalent work experience required. </span></span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">EXPERIENCE AND SKILLS</span></span></b></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Minimum 5 years of comprehensive experience with auditing medical, dental, and vision      claims required</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Proficient in Microsoft Word and Microsoft Excel</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Some familiarity with plan coding </span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Strong written and verbal communication skills required</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Ability to effectively manage assigned workload, including multiple tasks and competing priorities </span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">COMPETENCIES </span></span></b></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Accountability</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Analytical Thinking</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Collaboration</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Communication</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Customer Focus</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Functional Expertise</span></span></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Initiative</span></span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">PHYSICAL DEMANDS</span></span></b></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• <span style=\"color:#000000;\">This is a standard desk job requiring extended sitting and computer work</span></span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">. </span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><b><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">WORK ENVIRONMENT </span></span></b></span></span></p>\n\n<p style=\"margin-left:48px;\"><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:11pt;\"><span style=\"font-family:Arial, sans-serif;\">• Remote</span></span></span></span></p>\n\n<p> </p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive</span></span><span style=\"font-size:10.5pt;\"><span style=\"font-family:Calibri, sans-serif;\">.</span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.</span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">Compensation is not limited to base salary.  Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.</span></span></span></span></p>\n\n<p><span style=\"font-size:12pt;\"><span style=\"font-family:'Times New Roman', serif;\"><span style=\"font-size:10.5pt;\"><span style=\"font-family:Arial, sans-serif;\">Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time.  All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process.  It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.</span></span></span></span> </p>",
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