Apply on Employer Site

NC Department of Health and Human Services · 1 day ago

Quality Assurance Analyst

Pitt County, NC

Full-time

Onsite

Entry Level

$42K/yr - $73K/yr

1+ years exp

The North Carolina Department of Health and Human Services is one of the largest agencies in the state, responsible for the health and well-being of all North Carolinians. The Quality Assurance Analyst will assist with the execution of State required audit projects, track audit data, and support a team of auditors by answering questions and conducting policy research.

Health Care

Responsibilities

Assist with the execution of State required audit projects

Assist the Eligibility Audit Manager with tracking audit data and criteria to ensure the timely and successful completion of the audit

Capture and log audit data in addition to calculating statistical rates

Assist with case auditing as needed

Support team of auditors by answering questions and conducting policy research

Qualification

Medicaid policy knowledgeMedicaid eligibility systemStatistical proceduresCompliance monitoringPolicy research

Required

Bachelor's degree from appropriately accredited institution and one year of experience related to the area of assignment; or an equivalent combination of training and experience

Preferred

Demonstrated knowledge of Medicaid policy to research, evaluate, and analyze eligibility determinations for all Medicaid programs

Demonstrated knowledge and skill in utilizing the Medicaid eligibility system to evaluate beneficiary eligibility determinations and the MMIS claims system to obtain Medicaid payment amounts in an eligibility segment

Demonstrated knowledge of statistical procedures including data collection, analysis, and report preparation

Compliance monitoring experience for overseeing and managing quality assurance testing on an organization's day-to-day activities to ensure that compliance procedures are fully compliant with all regulatory requirements