Quality Review and Audit Associate

  • location: Nashville, TN
  • type: Temporary
  • salary: $15 per hour
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job description

Quality Review and Audit Associate

Randstad on West End is looking for a Quality Review and Audit Associate to support a Health Insurance client of ours in the Metro Center area of Nashville TN. The client is looking for candidates with Call Center/Customer Service experience, an audit background in Medicare, proficiency in Microsoft Word and Excel, and experience with Vertafore Systems would be preferred. This is a long term temporary position that lasts about 7 months and pays $15/hr and the hours are Mon-Fri 8am-4:30pm. The client requires an advanced background check and drug screening. If you are interested in the position please submit your resume to the posting and give us a call if you have the required experience, so that we can get the process started for you (615)-292-3816. Make sure all related experience is showcased on your resume. Thank you.

Responsibilities:
Audits and reviews the files of contracted agents and agencies to ensure that all regulatory and compliance requirements have been met and evidence is on file. Agents will be asked review a high volume of files and records within each file. This process will require research of internal databases for all required documentation and and the reporting of missing documents to the contracting leadership team. Processing of new agent/agency contracting packets to ensure compliance with CMS rules/regulations; Processing of maintenance packets for both agents and agencies to ensure compliance with CMS rules/regulations; Review and Validation of National Medicare Training Certificates; Activation of new agents and agencies; Processing of terminations (Both for-cause and not for-cause); Communication with topline broker agencies and markets to validate contracting and certification information for agents and agencies; Auditing of broker agent/agency files to ensure compliance with CHS and CMS policies/requirements

Working hours: 8:00 AM - 4:30 PM

Skills:
Required:
AUDIT
CALL CENTER/CUSTOMER SERVICE
CUSTOMER SERVICE
DATABASES
DETAIL ORIENTED

Additional Skills:
DOCUMENTATION
EXCEL
MEDICARE
TIME MANAGEMENT
WORD
AUDITING
AUDITS
CMS
CONTENT MANAGEMENT SYSTEM
CUSTOMER SERVICE ORIENTED
MAINTENANCE
MICROSOFT EXCEL
MICROSOFT OFFICE
MICROSOFT WORD
RETAIL SALES
TERMINATIONS
TRAINING

Qualifications:
Agents are required to be proficient in the use of the Microsoft Office suite, specifically word and excel, and must also be able to display effective verbal and written communicate skills. Effective time management is a requirement and the agent must be flexible to work evening and weekend overtime as required during the heavier volume times; Efficient to Multi-Tasking capabilities/ navigate different systems; Versatile/adaptable: Constant changing environment (Priorities can change daily); Self-Sufficient ; Someone who can stay on task and when work is completed will reach out to leadership team for additional tasks; Above average verbal and written communication skills; Proficient with Excel and Word software and also with Windows based applications; Call Center/Customer Service experience (candidates who are used to sitting in an office setting); Detail Oriented; Audit background in Medicare is a plus; Experience with Vertafore Systems is a plus but not required

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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