Health Insurance
6 hours ago
Overview:
Health Insurance QA - UW, Claims and Finance knowledge
**Responsibilities**:
**Quality Assurance in Underwriting**:
- Review underwriting decisions to confirm they align with risk assessment protocols.
- Collaborate with underwriters to refine risk evaluation processes.**Claims Management**:
- Monitor and audit claims processing to ensure adherence to regulatory standards.
- Identify discrepancies or errors in claims and work with the claims team to resolve them.
- Develop and implement quality control procedures to enhance claims accuracy and efficiency.**Financial Oversight**:
- Ensure financial transactions related to claims and underwriting are accurately recorded.
- Conduct regular audits of financial records to detect and prevent fraud.
- Work with the finance team to streamline financial reporting and compliance.
Qualifications:
- **Educational Background**:
- Degree in Health Information Management, Insurance Studies, Finance, or a related field.
- ** Experience**:
- Proven experience in quality assurance within the insurance industry.
- Familiarity with underwriting processes, claims management, and financial auditing.
- ** Technical Skills**:
- Proficiency in using insurance software and data analysis tools.
- Strong analytical and problem-solving skills.
- ** Soft Skills**:
- Excellent attention to detail and organizational skills.
- Strong communication and teamwork abilities.
**Experience**:
4 to 7 years
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