{"schemaVersion":"jobsearcher.job.v1","id":"aa69f43bb71d3596207cf429","url":"https://jobsearcher.com/jobs/aa69f43bb71d3596207cf429","canonicalUrl":"https://jobsearcher.com/jobs/aa69f43bb71d3596207cf429","title":"Remote Claims QA Analyst","description":"Employer Industry: Healthcare ServicesWhy Consider This Job Opportunity Remote work offered, providing flexibility in your work environment Comprehensive benefits package including Medical, Dental, Vision, Life, HSA, and 401(k) Paid training to ensure you are well-prepared for success in your role Paid Time Off (PTO) and 7 paid holidays for work-life balance Supportive team culture that values internal growth and career advancementWhat To Expect (Job Responsibilities) Conduct detailed audits of denied, underpaid, and processed claims using EZCap to ensure compliance with provider contracts Analyze provider disputes to identify patterns or recurring issues for continuous improvement Collaborate with relevant teams to implement corrective actions and enhance process efficiencies Track and report performance metrics related to claims accuracy and dispute resolution efficiency Participate in internal and external audits, ensuring alignment with regulatory requirementsWhat Is Required (Qualifications) High school diploma or equivalent 3-5 years of experience as a Quality Analyst in healthcare, TPA, or health plan settings Hands-on experience with EZCap (strongly preferred) Familiarity with Medi-Cal and commercial insurance claims Strong analytical and problem-solving skills, with attention to detail in documentation and complianceHow To Stand Out (Preferred Qualifications) Experience with other claim adjudication platforms and provider systems Familiarity with DHCS, DMHC, and CMS dispute handling regulations Excellent verbal and written communication skills Ability to manage multiple tasks and meet deadlines#HealthcareServices #RemoteWork #ClaimsProcessing #CareerAdvancement #QualityAssurance\"We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.\"","company":"Talentify","rawCompany":"talentifyio","isRemote":true,"isActive":false,"createdAt":"2026-05-28T13:20:09.205Z","occupations":[{"code":"19-4099.01","title":"Quality Control Analysts","slug":"quality-control-analysts"},{"code":"11-3051.01","title":"Quality Control Systems Managers","slug":"quality-control-systems-managers"},{"code":"13-1031.00","title":"Claims Adjusters, Examiners, and Investigators","slug":"claims-adjusters-examiners-and-investigators"}],"industries":[{"code":"524298","title":"All Other Insurance Related Activities","slug":"all-other-insurance-related-activities"},{"code":"524292","title":"Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds","slug":"pharmacy-benefit-management-and-other-third-party-administration-of-insurance-and-pension-funds"},{"code":"524291","title":"Claims Adjusting","slug":"claims-adjusting"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Remote Claims QA Analyst","description":"Employer Industry: Healthcare ServicesWhy Consider This Job Opportunity Remote work offered, providing flexibility in your work environment Comprehensive benefits package including Medical, Dental, Vision, Life, HSA, and 401(k) Paid training to ensure you are well-prepared for success in your role Paid Time Off (PTO) and 7 paid holidays for work-life balance Supportive team culture that values internal growth and career advancementWhat To Expect (Job Responsibilities) Conduct detailed audits of denied, underpaid, and processed claims using EZCap to ensure compliance with provider contracts Analyze provider disputes to identify patterns or recurring issues for continuous improvement Collaborate with relevant teams to implement corrective actions and enhance process efficiencies Track and report performance metrics related to claims accuracy and dispute resolution efficiency Participate in internal and external audits, ensuring alignment with regulatory requirementsWhat Is Required (Qualifications) High school diploma or equivalent 3-5 years of experience as a Quality Analyst in healthcare, TPA, or health plan settings Hands-on experience with EZCap (strongly preferred) Familiarity with Medi-Cal and commercial insurance claims Strong analytical and problem-solving skills, with attention to detail in documentation and complianceHow To Stand Out (Preferred Qualifications) Experience with other claim adjudication platforms and provider systems Familiarity with DHCS, DMHC, and CMS dispute handling regulations Excellent verbal and written communication skills Ability to manage multiple tasks and meet deadlines#HealthcareServices #RemoteWork #ClaimsProcessing #CareerAdvancement #QualityAssurance\"We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.\"","datePosted":"2026-05-28T13:20:09.205Z","dateModified":"2026-05-28T13:20:09.205Z","hiringOrganization":{"@type":"Organization","name":"Talentify","sameAs":"https://jobsearcher.com"},"jobLocationType":"TELECOMMUTE","applicantLocationRequirements":{"@type":"Country","name":"US"},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"aa69f43bb71d3596207cf429"},"url":"https://jobsearcher.com/jobs/aa69f43bb71d3596207cf429"}}