QA Specialist III - Client Success

The QA Specialist III - Client Success is a role focused on ensuring accuracy, consistency, and excellence within healthcare payment integrity operations. Key responsibilities include:

• Delivering advanced quality assurance expertise across complex healthcare payment integrity processes.
• Avoiding inaccuracies, ensuring compliance, and aligning with established quality standards during advanced quality assurance reviews of overpayment accounts.
• Identifying recurring quality trends, operational risks, and process gaps, and recommending improvements to enhance efficiency and consistency.
• Onboarding, coaching, and sharing knowledge with new team members by providing guidance and best practices.
• Participating in new client implementations by collaborating with operational leadership, implementation teams, client success teams, and other stakeholders.
• Establishing, refining, and maintaining quality assurance requirements, methodologies, documentation, and review processes for new and existing clients.
• Analyzing client communications and implementation discussions to incorporate evolving requirements into quality standards and operational workflows.
• Communicating potential risks, ambiguities, and process gaps while ensuring appropriate clarification and resolution.

To succeed in this role, the ideal candidate should possess:

• A strong background in healthcare knowledge, analytical capabilities, and experience with quality assurance processes.
• A demonstrated track record in healthcare operations, payment integrity, overpayment recovery, or related fields.
• A solid understanding of overpayment recovery services and healthcare payer requirements.
• Excellent analytical skills with the ability to evaluate complex information and identify trends or risks.
• Strong communication and interpersonal skills, with the ability to collaborate effectively with clients, leadership, and peers.
• The ability to quickly learn new processes, make an immediate impact, and deliver value-driven solutions.
• A strong attention to detail and commitment to accuracy.
• The ability to manage priorities and perform effectively under tight deadlines.
• A team-oriented mindset with a desire to contribute to organizational growth and continuous improvement.

Benefits offered include:

• A competitive compensation package designed to support employee growth and well-being.
• Comprehensive health insurance benefits.
• A 401(k) retirement plan with employer match.
• Paid parental leave.
• Opportunities for professional development and career growth.
• A supportive culture focused on improving healthcare outcomes.
• Opportunities to contribute to meaningful initiatives that reduce healthcare waste and improve access to care.