Description:

Job Title: Quality Assurance Specialist

About Medallion:

Healthcare is going through an unprecedented transformation towards digital care. Medallion provides the critical administrative infrastructure to make that change possible. Our platform enables organizations to license their providers in new states, verify existing credentials, and get in-network with health plans. In just over two years, we’ve launched our platform, built an all-star team, powered hundreds of great companies, and served thousands of healthcare providers across the industry. To date, Medallion has saved over 250,000 administrative hours for our customers!

Founded in 2020, Medallion has raised $85M from world-class investors like Sequoia Capital, Google Ventures, Spark Capital, Optum Ventures, and Salesforce Ventures.

About the Role:

As a Quality Assurance Specialist at Medallion, you will ensure payer enrollment files are adhering to our quality standards. We are looking for someone extremely detail-oriented, as this team member will be responsible for identifying errors or omissions in applications and taking corrective actions as appropriate.

This role reports to one of the Payer Enrollment Team Leads and base compensation for this role may land between $22-$30 per hour. In addition to base salary, Medallion offers equity, and benefits as part of the total compensation package. Many factors are considered when determining pay including: market data, geographic location, skills, qualifications, experience, and level.

Responsibilities:

• Perform final audits of soon-to-be submitted applications and update accordingly
• Complete internal SLAs applications, follow-ups, payer requested info, etc
• Ensure Payer Enrollment files are submitted within predetermined SLA’s
• Work with team members to ensure internal/provider tasks are comprehensive, clear, and being actioned in a timely manner.
• Client Escalations
  • Review escalation, RCA and CAP with Head of Licensing
  • Identify optimization opportunities within current processes

Skills and Requirements: 

• 1+ years of payer enrollment experience with applications and processes
• 1+ years of quality assurance experience
• Proficient in Microsoft Excel
• Strong Analytical skills: must be able to spot trends and identify outliers
• Obsessed with details: able to identify discrepancies in information, processes, and policies.
• Effectively communicate with stakeholders at various levels.
• Must be able to work cohesively in a team oriented environment and be able to foster good working relationships with others both within and outside the organization

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