Job Details

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.

Job Title: Operations - Quality Assurance Specialist III.
Location: Owings Mills, MD.

Job description:
Purpose:

• The Quality Assurance Specialist III is an advanced-level auditor position performing in-depth system and procedural audits.
• This role conducts regular reviews and audits of internal controls within each functional area for strengths and weaknesses ensuring special focus to the specific risk areas.
• The incumbent is considered a Subject Matter Expert (SME) in their audit field and provides a comprehensive analysis of transaction, systems and procedures.

Essential Functions:

• 50% Audits assigned function (service, claims, enrollment) for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Identifies, documents and reports transaction errors utilizing departmental quality monitoring templates in a timely manner to ensure prompt resolution
• 20% Assists in development of special department projects and participates in department and divisional projects
• 20% Conducts structured coaching and feedback sessions. Provides suggestions and creates improvement plans for areas of deficiency within the group or for an individual
• 10% Participates in the creation and implementation of new methods, processes and/or products

Qualifications:

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
• The requirements listed below are representative of the knowledge, skill, and/or ability required.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Preferred Qualifications:

• Knowledge of quality assurance and production technologies., Expert.
• Proficient in Microsoft Office programs., Proficient.
• Extensive knowledge of industry standards, quality control techniques and procedures., Advanced.
• Excellent communication skills both written and verbal., Advanced.
• Extensive analytical and problem-solving skills, Advanced.
• Strong interpersonal skills, Advanced.
• Excellent research and organizational skills, Advanced.

Licenses/Certifications

• ECA Certified Quality Assurance Manager. Coding certification (CPC or COC, CPMA et.), Claims and insurance experience. Medical records auditing.

Education Level:

• High School Diploma or GED

Experience:

• 5 years Auditing, Quality Assurance, Operations, Training, Project Management or comparable work experience. 2 years' experience as Quality Assurance Specialist II.

Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.