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Quality Assurance Specialist needs claims , appeals , call center experience

Quality Assurance Specialist requires:

• Hybrid of 2 days/week
• Works grievance and appeals
• Prior work experience (G&A, claims, appeals, call center, etc.)
• Strong written and verbal communication skills, and health claims processing background

Quality Assurance Specialist duties:

• Review and resolve member and provider complaints
• Maintain accurate, complete complaint/grievance records in the electronic database.
• Coordinates Complaint , preparing the agenda
• Notifying participants,