Quality Analyst jobs in United States
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Highmark Health · 1 day ago

Quality Analyst

positionUnited States
timeFull-time
remoteRemote
seniorityMid Level
money$22.71/hr - $35.18/hr
date3+ years exp

Highmark Inc. is a healthcare organization seeking a Quality Analyst to manage and analyze data related to complex adjusted claims. The role involves ensuring compliance with adjustment processes, conducting audits, and training operational staff while developing reports on findings and trends.

Health CareHospital
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H1B Sponsor Likelynote

Responsibilities

Ensure the consistent, accurate, efficient, and appropriate processing of adjustments and/or duplicate claims through an audit sampling review process
Develop management reports detailing the review process findings as well as trending/analysis reports
Monitor and train quality and operational staff
Identify any potential fraudulent activity relating to adjustment and/or duplicate claim processing and address any and all deficiencies to remain compliant and report non compliant areas
Other duties as assigned or requested

Qualification

Claims processing experienceAnalytical toolsMicrosoft Office proficiencyProcess improvement methodologiesAnalytical skillsVerbal communication skillsWritten communication skillsInterpersonal skillsOrganizational skillsProblem-solving skillsCreative skills

Required

High School Diploma/GED
3-5 years of relevant, progressive experience in the area of specialization. Exempted experience requirements effective August 2016
Experience in claims and/or inquiry processing or equivalent experience in quality
Experience with Microsoft Office Products

Preferred

Bachelor's Degree

Company

Highmark Health

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Highmark Health is an integrated health care delivery and financing network.
dateFounded in 1848
location
Pittsburgh, Pennsylvania, USA
people-size10001+ employees
web-link
https://www.highmarkhealth.org/hmk

H1B Sponsorship

Highmark Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (38)
2024 (34)
2023 (55)
2022 (75)
2021 (54)
2020 (58)

Funding

Current Stage
Late Stage
Total Funding
$6.75M
Key Investors
Henry L. Hillman FoundationRichard King Mellon Foundation
2025-06-11Grant· $1.75M
2021-05-10Grant· $5M

Leadership Team

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David Holmberg
President and Chief Executive Officer
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Karen Hanlon
Executive Vice President, Chief Operating Officer
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Recent News

Seattle TechFlash
Highmark Health's newly promoted president talks about navigating change (Newly Minted)
2025-12-29
PR Newswire
AHN, Highmark Health Aim to Bridge Language Gaps in Health Care with New 'I Speak' Card Program
2025-12-22
PR Newswire
Highmark Health Reports $24.6 Billion in Revenue, $69 Million Net Loss for the Nine Months ended Sept. 30, 2025; Maintains Growth Posture Amid Continuing Industry Challenges
2025-12-15
Company data provided by crunchbase