Full-Time
Level: Mid
Travel: No
SuccessProfileWho is the ideal Promedica employee? We’re looking for people to join our team who are motivated by making an impact and doing meaningful work.
Responsible 10
Compassionate 9
Communicator 9
Adaptable 9
Multi-tasker 8
Additional success profiles:
Detail oriented, Flexible, Helpful, Patient, Responsible, Sincere, Understanding
Benefits
Professional Growth
Retirement & Savings Plan
Innovative Training Programs
Tuition AssistanceCareer Stability
Comprehensive Health Coverage
Job Requirements
ProMedica’s health plan, Paramount Insurance, offers health insurance products across six Midwest states. Paramount is an Ohio-based health insurance company, headquartered in Toledo. The organization has more than 800 employees dedicated to serving their health plan members.
Paramount offers Medicare Advantage and Marketplace Exchange health plans for individuals and families. Paramount maintains accreditation by the National Committee for Quality Assurance (NCQA) for their HMO and Medicare Advantage products.
In addition, Paramount has a full complement of insurance products for employers of any size, including medical, dental, vision and workers’ compensation, as well as vocational rehabilitation, life-care planning and wellness.
As a part of ProMedica, Paramount is driven by ProMedica’s mission to improve your health and well-being. ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health. Paramount strives to provide an exceptional experience to every member. For more information about Paramount, please visit our website. http://www.paramounthealthcare.com .
Basic Purpose:
Perform quality assurance functions as they pertain to claims transactions audits by means of identifying, documenting, and communicating information. The Claims QA Auditor maintains, and provides statistical reports to claims management as requested. Works cooperatively with the claims trainer and claims team leaders to propose and implement solutions to always provide the best outcomes for our groups, members, and providers. Supports activities related to internal/external audits to ensure timely dissemination of requested information/materials.
No positions report directly to this position.
Primary Duties:
General Information/Qualifications:
ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedica
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact (see below)
Equal Opportunity Employer/Drug-Free Workplace