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Quality Control Analyst

Company: VirtualVocations
Location: Bell Gardens
Posted on: May 3, 2025

Job Description:

A company is looking for a Quality Control Analyst - Remote.
Key Responsibilities

Audit claims for accuracy, including complex and high dollar claims, and review dispute requests from providers
Identify system configuration issues affecting claims processing and communicate with relevant internal departments
Create detailed audit findings and recommendations, and conduct retrospective audits of paid claims

Required Qualifications

High school diploma or equivalent required; Bachelor's degree in Finance or Accounting preferred
5 years of experience as a Quality Control Analyst
2-3 years of experience as a Claims Adjuster
Strong knowledge of Managed Healthcare and coding regulations (CPT, RBRVS, DRG, HCPCS, ICD-9, ICD-10)
No certification required

Keywords: VirtualVocations, Rosemead , Quality Control Analyst, Professions , Bell Gardens, California

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