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Quality assurance analyst

Randstad
Chicago, IL Full Time
POSTED ON 2/26/2025
AVAILABLE BEFORE 5/23/2025

Job Posting Summary :

We are looking for an experienced QA Analyst with 4-7 years of experience for a fully remote position. The ideal candidate must possess good analytical and critical thinking skills. Experience in Pharmacy Benefit Management (PBM) and claims is required. This role offers a negotiable salary based on qualifications. If you meet these criteria and are interested in the position, please send your resume to jenni.josten@randstadusa.com for review and potential phone screening.

salary : $45 - $55 per hour

shift : First

work hours : 8 AM - 4 PM

education : Associate

Responsibilities

  • Responsible for providing quality assurance for internal processes and suggesting additional additions, when

appropriate.

  • Understands and defines the performance and quality standards expected of Claims Processing employees.
  • Evaluates quality standards from an objective point of view and ensures the proper checks and balances are
  • applied to all parts of the Claims Processing procedures.

  • Responsible for being fully trained in both the claims processor and other internal programs so an adequate
  • knowledge base can be used when evaluating and following procedures.

  • Participate in the design of procedures of but not limited to reimbursement audits, group / plan design, in-
  • house ticket, group / plan changes, SOC audits, and QA testing in internal program(s).

  • Report findings and follow through with resolution resulting from claims analysis.
  • Document results and follow through resolution within departments tracking system.
  • Participate in a culture of continuous improvement, open door policy and internal support system.
  • Abide by all obligations under HIPAA related to Protected Health Information (PHI).
  • 2 years of PBM experience in a Quality Analysis and Controls setting OR
  • 3 years of PBM experience in Benefit Design execution or Implementation at a high level
  • Skills

  • Claims
  • Analytical Thinking
  • critical thinking
  • Managing tickets
  • HIPAA
  • Qualifications

  • Years of experience : 4 years
  • Experience level : Experienced
  • 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.

    Equal Opportunity Employer : Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

    At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

    Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).

    This posting is open for thirty (30) days.

    It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

    Salary : $45 - $55

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