Remote opportunity at
WelbeHealthClaims Quality Assurance Supervisor
WelbeHealth is seeking a Claims Quality Assurance Supervisor to manage a team of para-professional staff members. This full-time, remote position focuses on pre- and post-payment audits…
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About This Role
WelbeHealth is seeking a Claims Quality Assurance Supervisor to manage a team of para-professional staff members. This full-time, remote position focuses on pre- and post-payment audits to verify that claims are handled efficiently, accurately, and in compliance with all relevant regulations and contracts. The employer supports seniors in the community through a dedicated participant focus and collaborative culture. This role suits a detail-oriented professional who can analyze operational trends, guide…
Job Description
WelbeHealth is seeking a Claims Quality Assurance Supervisor to manage a team of para-professional staff members. This full-time, remote position focuses on pre- and post-payment audits to verify that claims are handled efficiently, accurately, and in compliance with all relevant regulations and contracts. The employer supports seniors in the community through a dedicated participant focus and collaborative culture. This role suits a detail-oriented professional who can analyze operational trends, guide staff development, and lead data-driven auditing procedures within a healthcare setting.
The supervisor will act as the primary escalation point for quality assurance questions, build team workflows, and collaborate across departments to implement process enhancements. Compensation consists of a base salary paired with a bonus, alongside a comprehensive benefits package. Candidates must note that WelbeHealth enforces a vaccination policy requiring proof of vaccination or a declination form prior to starting employment.
Responsibilities
- Supervise and direct daily auditing operations to confirm claims are paid accurately and on time
- Identify operational gaps, formulate solutions, and recommend improvements for processing and training
- Monitor team activities, track audit progress, and report status updates to impacted parties
- Collaborate with management and other departments to implement workflow changes based on identified trends
- Develop and update team resource materials, procedures, and workflows
- Serve as the primary escalation contact and resource for quality assurance inquiries
- Evaluate staff performance, provide coaching, and address performance issues or training gaps
Requirements
- At least five years of experience working in health plans such as managed care or PACE
- Background in a claims processing environment with a focus on claims auditing
- Progressively responsible experience demonstrating the ability to mentor team members
- Working knowledge of Medicaid and Medicare billing guidelines
- Ability to analyze regulatory and contractual requirements affecting claims payment and resolution
- Experience leading within a data-driven organization and using reports to manage projects and staff
- Compliance with company vaccination policies
Qualifications
- Associate degree preferred or relevant professional experience in a health plan environment specializing in billing, coding, claims payment, or related functions
Core Skills
Benefits
- Medical, dental, and vision insurance coverage
- 17 personal time off days annually
- 12 observed holidays per year
- 6 sick days per year
- 401(k) savings plan with a match
- Base salary plus bonus compensation package
Frequently Asked Questions
Answers are based only on the employer’s listing; where it doesn’t say, neither do we.
Is this position remote?
Yes, the source posting designates this role as remote.
What is the salary range for this role?
The compensation offering ranges from $99,309.58 to $131,088.64 per year, consisting of a base salary plus a bonus.
What experience is required for this position?
Applicants need a minimum of five years of experience in health plans like managed care or PACE, with a specific focus on claims processing and auditing, plus demonstrated mentoring abilities and knowledge of Medicare or Medicaid billing guidelines.
Are there vaccination requirements for employment?
Yes, WelbeHealth requires proof of vaccination or a vaccine declination form prior to employment.
Sample Interview Questions
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