Quality Auditor

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.  

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.  

Medica's Quality Auditor audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures, gathers findings at a macro level and makes recommendations for process improvement and efficiencies.  The Quality Auditor performs professional responsibilities with direct supervision on method and processes. Performs other duties assigned.

Qualifications:

• Bachelor's degree or equivalent experience in related field
• Previous experience within Call Center Compliance and/or Quality Auditing, Claims Audit and/or Claims Processing required

Skills and Abilities:

• Excellent attention to detail
• Ability to meet deadlines
• Effectively able to function independently and in a team environment
• Strong organizational and prioritizing skills
• Excellent analytical/problem solving ability
• Strong communication skills - verbal and written
• Adaptable and flexible to a changing environment

This position is a Remote role. To be eligible for consideration, candidates must have a primary home address located within any state where Medica is registered as an employer - AR, AZ, FL, GA, IA, IL, KS, KY, MI, MN, MO, ND, NE, OK, SD, TN, TX, VA, WI 

The full salary grade for this position is $45,900 - $78,600. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $45,900 - $68,775. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.  In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.  

The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.  

Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. 

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.