Quality Lead

Job Description

Quality Lead

Location: Scottsdale, AZ

Duration: till end-Sep with very high probability of extensions.

Responsibilities:

1. Managing the performance of contingent staff.
2. Monitoring the production and quality of processed claims to ensure all CMS and Contractual standards are met.
3. Managing inventory by assigning work and setting up daily goals for quality coordinators.
4. Helping supervisor in creating error reports, pareto charts, and working with the processing team to provide feedback for coaching opportunities.
5. Tracking individual performance based on claims reviewed and errors missed for contingent resources.
6. Providing feedback to contingent staff.
7. Resolving daily impediments to ensure flawless execution of the quality control process.
8. Responsible for 25% of the time to do actual quality control execution work for high-risk clients.
9. Overseeing any department issues and working with internal partners to track the resolution of any issues.

Required Qualifications:

1. 3+ years of experience in the health care industry
2. 1+ years of experience in quality control and claims audit
3. 1+ years of supervisory experience
4. 1+ years of experience working with Excel, Word, and PowerPoint
5. 1+ years in a role requiring an understanding of Human Resource policies

Preferred Qualifications:

1. 1+ years previous experience in pharmacy and/or medical claims processing
2. Experience with Med D regulations
3. Ability to run a high volume production team with an emphasis on quality output
4. Excellent verbal and written communication skills
5. Ability to interact with internal partners and clients in a professional manner
6. Ability to make sound operational decisions in a fast-paced, high-stress environment

Additional Information

All your information will be kept confidential according to EEO guidelines.