Quality Control and Compliance Associate
3.
0 Ewing, NJ Ewing, NJ Full-time Full-time $45,300 - $49,000 a year $45,300 - $49,000 a year Reporting to the Medical Services QC Supervisor in our West Trenton, New Jersey corporate office, the QC & Compliance Associate is responsible and accountable for conducting complete and thorough reviews of medical bills and participating in targeted compliance and process audits to support the department.
This role also supports the MSA QC Supervisor in completing compliance checklist reviews for both PIP and Workers' Compensation Claims.
This is a hybrid position that requires at least three days a week in the office.
Responsibilities Include:
Assist the MSA QC Supervisor in completing PIP and WC compliance checklist reviews Gather exhibits required, identify items needing sign off from other departments outside of MSA, and assist with compiling regulations for sign off Establish audit parameters/thresholds, gather and compile data for closed claim and process audits for all identified MSA business units as specified by Department Supervisor Prepare target audit samples using SAS EG, Excel, and/or other tools Collect and report audit findings Consolidate data into report for supervisor review Identify trends or patterns Perform pre- and post-payment audits on WC and PIP medical payment in accordance with established procedures.
Accurately maintain and document audit findings.
Identify trends or patterns in errors for supervisor Perform ad hoc tasks assigned by the Supervisor and/or MSA Management Position Requirements:
High School diploma or GED required, bachelor's degree preferred 2
years proficient experience in using Microsoft, Excel and PowerPoint required Knowledge of the following systems a plus:
Decision Point, Agile Point, Claim Center and Onbase Team player with demonstrated ability to work in a highly collaborative environment Good analytical, organizational and time-management skills Decision-making and multi-tasking capabilities Strong verbal and written communication skills NJM is proud to be an equal opportunity employer.
We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
Job Type:
Full-time Pay:
$45,300.
00 - $49,000.
00 per year
Benefits:
401(k) 401(k) matching Dental insurance Employee assistance program Employee discount Flexible spending account Health insurance Health savings account Life insurance Paid time off Professional development assistance Referral program Tuition reimbursement Vision insurance Experience level:
1 year 2 years Schedule:
Day shift Monday to Friday Work setting:
Hybrid work Office Work Location:
Hybrid remote in Ewing, NJ 08628.
Estimated Salary: $20 to $28 per hour based on qualifications.
0 Ewing, NJ Ewing, NJ Full-time Full-time $45,300 - $49,000 a year $45,300 - $49,000 a year Reporting to the Medical Services QC Supervisor in our West Trenton, New Jersey corporate office, the QC & Compliance Associate is responsible and accountable for conducting complete and thorough reviews of medical bills and participating in targeted compliance and process audits to support the department.
This role also supports the MSA QC Supervisor in completing compliance checklist reviews for both PIP and Workers' Compensation Claims.
This is a hybrid position that requires at least three days a week in the office.
Responsibilities Include:
Assist the MSA QC Supervisor in completing PIP and WC compliance checklist reviews Gather exhibits required, identify items needing sign off from other departments outside of MSA, and assist with compiling regulations for sign off Establish audit parameters/thresholds, gather and compile data for closed claim and process audits for all identified MSA business units as specified by Department Supervisor Prepare target audit samples using SAS EG, Excel, and/or other tools Collect and report audit findings Consolidate data into report for supervisor review Identify trends or patterns Perform pre- and post-payment audits on WC and PIP medical payment in accordance with established procedures.
Accurately maintain and document audit findings.
Identify trends or patterns in errors for supervisor Perform ad hoc tasks assigned by the Supervisor and/or MSA Management Position Requirements:
High School diploma or GED required, bachelor's degree preferred 2
years proficient experience in using Microsoft, Excel and PowerPoint required Knowledge of the following systems a plus:
Decision Point, Agile Point, Claim Center and Onbase Team player with demonstrated ability to work in a highly collaborative environment Good analytical, organizational and time-management skills Decision-making and multi-tasking capabilities Strong verbal and written communication skills NJM is proud to be an equal opportunity employer.
We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
Job Type:
Full-time Pay:
$45,300.
00 - $49,000.
00 per year
Benefits:
401(k) 401(k) matching Dental insurance Employee assistance program Employee discount Flexible spending account Health insurance Health savings account Life insurance Paid time off Professional development assistance Referral program Tuition reimbursement Vision insurance Experience level:
1 year 2 years Schedule:
Day shift Monday to Friday Work setting:
Hybrid work Office Work Location:
Hybrid remote in Ewing, NJ 08628.
Estimated Salary: $20 to $28 per hour based on qualifications.
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