Intake Quality Assurance Specialist
Core
Implement quality measurements, scoring, and performance improvement data to enhance operational efficiency and exceed industry standards for quality performance in US healthcare payer processes.
Role type
Senior Intake Quality Assurance Specialist (Healthcare Operations)
Builds
Operational efficiency, training programs, SOPs, and workflow improvements for Intake Operations.
Domain
US Healthcare Payer Processes / Medical Billing / Claims / Prior Authorization
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
US healthcare operations experience, medical billing, claims, prior authorization, HIPAA regulations, quality assurance, data analysis, problem solving, planning, stakeholder interaction
Preferred skills
Google Workspace proficiency, quality management systems, structured QA audits, adult learning theory, information security practices
Technologies
Mac-based environment, Google Workspace (Sheets, Docs, Forms), quality management systems
Responsibilities
Translate QA findings into insights and recommendations for operational leaders; Develop and deploy structured coaching sessions based on audit findings; Create and ensure accuracy of SOPs, job aids, and workflow guides; Facilitate onboarding and upskilling sessions; Lead QA/Training side of project implementations; Partner with cross-functional teams to validate workflow changes; Manage multiple concurrent priorities with independence; Step into operational queues to maintain service levels during high-volume periods.
Seniority
Mid-Senior, hands-on IC with 5-7 years of experience