New York Claims Quality Analyst

Job Summary

A company is looking for a Claims Quality Analyst.

Key Responsibilities

• Manage the medical file review process, ensuring client questions are addressed and reports are accurate
• Conduct quality audits of reports and follow up with reviewers and clients as needed
• Communicate effectively with customers, reviewers, and the Operations team regarding peer reviews

Required Qualifications

• Preferred Associate's Degree or Bachelor's Degree
• Experience in a healthcare and/or insurance setting, particularly in NY Workers Compensation
• Operations experience with Peer Review, UR, and/or case management
• Familiarity with technology-based processes in a business environment
• Ability to handle high volume tasks and meet deadlines