25 days old

Quality Audit Specialist

Kelly Services
Rochester, NY 14608
**_Quality Audit Specialist /_** **Rochester, New York**

Kelly Services is currently seeking **a Quality Audit Specialist** for one of our top clients in Rochester, New York.

Pay rate: **$18.33** per hour

Hours: M-F 8:00a-5:00p

Long term opportunity with the chance for hire

**Job Description:**

+ Performs daily, weekly and monthly sample audits in accordance with Centers for Medicare & Medicaid Services, federal mandates, company and departmental policies

+ These audits include, but are not limited to, reviewing enrollment, billing, reconciliation and system transactions across applicable systems and servicing areas for accuracy and timeliness

+ Prepares and communicates individual (e.g. appropriate Enrollment & Billing employees), work team(s) and departmental accuracy and timeliness metrics on a daily, weekly and monthly basis to department management, staff and executive leaders

+ Discusses observed inconsistencies and errors with appropriate management and front-line staff to identify root causes of errors, verifies findings and communicates results to ensure remediation plans are accurate, effective and timely

+ Proposes recommendations for workflow modifications, processing guidelines, system documentation and/or training documentation

+ Performs intra-departmental reporting consisting of data input to document daily, weekly and monthly work and performance measures

+ Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures

+ Regular and reliable attendance is expected and required.

**Minimum Requirements**

+ AAS Degree in Business Administration or relevant field with a minimum of three years progressive experience working in a Claims/M&B/Service environment/Quality Auditing within Health Plan or related field. In lieu of degree, a minimum of six years progressive experience working in a Claims/M&B/Service environment/Quality Auditing within Health Plan or related field

+ Must possess auditing skills

+ Must have analytical, problem-solving, and presentation skills

+ Must have the ability to complete thorough research and exercise good judgment

+ Must be able to prioritize assignments and work accurately and independently

+ Must have a working knowledge of PCs and Microsoft Office applications

+ Must possess effective verbal and written communication skills. Willingness and comfort presenting to small groups of employees. Ability to report findings to managers and staff

+ Strong attention for detail

+ Medical insurance, Healthcare and Auditing experience required

As a Kelly Services candidate you will have access to numerous perks, including:

+ Exposure to a variety of career opportunities as a result of our expansive network of client companies

+ Career guides, information and tools to help you successfully position yourself throughout every stage of your career

+ Access to more than 3,000 online training courses through our Kelly Learning Center

+ Weekly pay and service bonus plans

+ Group- rate insurance options available immediately upon hire*

Apply Today!

_*Available for purchase and administered by a designated third-party vendor_

**Why Kelly** **** **?**

At Kelly
Services , we work with the best. Our clients include 95 of the Fortune
100 companies, and more than 70,000 hiring managers rely on Kelly annually to access
the best talent to drive their business forward. If you only make one career connection today, connect
with Kelly.

**AboutKelly Services** ****

As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 people
around the world and have a role in connecting thousands more with work through our global network of
talent suppliers and partners. Revenue in 2017 was $5.4 billion. Visit and connect with us on Facebook, LinkedIn and Twitter .

Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females,
Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and is
committed to employing a diverse workforce. Equal Employment Opportunity
is The Law.
Posted: 2019-07-24 Expires: 2019-08-24

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Quality Audit Specialist

Kelly Services
Rochester, NY 14608

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