Claims Quality Inspector

A company is looking for a Claims Quality Inspector. Key Responsibilities: Conduct accurate and timely quality reviews of claim adjudication activities Perform quality audits on Membership eligibility and enrollment entry Document findings in the QC tracking system and communicate error determinations Required Qualifications: High School Diploma or GED required At least 2 years of experience in a Claims or QC/Inspector role within the managed care industry, or 5 years of experience processing medical claims Bachelor's degree and/or Claims adjudication or medical billing/coding certification preferred Prior experience within the Medicare, Medicaid, or regulated Managed Care payer environment is preferred Pre-employment background check required

Created: 2026-03-05