Quality Control Auditor

RAM Technologies

. Complete standard functional pre- and post-transaction outcome reviews to determine transaction accuracy and compliance .

Posted 9/18/2026full-timeRemote • United StatesJuniorMid-Level💰 $45,000 - $50,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in conducting quality audits and compliance reviews within the healthcare payer segment, with a strong focus on Medicare Advantage and Managed Medicaid. Proficient in documenting findings and collaborating on continuous quality improvement initiatives while adhering to HIPAA and HITECH regulations.

Highest-signal resume keywords

Quality Audit ExperienceHealthcare Industry KnowledgeCompliance Risk IdentificationMS Office ProficiencyAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality Review DocumentationCoding AccuracyBenefit Payment AnalysisContract InterpretationCompliance with PoliciesRoot Cause AnalysisCorrective Action DefinitionSystem Configuration ReviewBPaas Environment Experience

Soft Skills

Interpersonal CommunicationListening SkillsWritten CommunicationOral Communication

Tools & Technologies

MS PowerPointMS WordMS ExcelMS Access

Industry Keywords

Healthcare Payer SegmentMedicare AdvantageManaged MedicaidHIPAA ComplianceHITECH CompliancePHI SafeguardingPII Safeguarding

About the role

Key responsibilities & impact

Complete standard functional pre- and post-transaction outcome reviews to determine transaction accuracy and compliance
Stay current on expected operational outcomes
Align quality reviews with applicable processes, contractual service-level agreements, and compliance guidelines
Select audits through random processes and/or other criteria
Perform random and/or targeted periodic quality audits
Clearly document the outcomes of each quality audit
Aid in identifying compliance risks, conducting root cause analysis, and defining corrective action steps
Provide operational delivery teams with feedback to address findings
Collaborate with operations on continuous quality improvement initiatives
Recommend improvements to quality, workflow processes, policies, and procedures
Contribute independently and collaboratively to moderately complex project work

Requirements

What you’ll need

Typically requires an associate degree
2+ years' healthcare industry experience working in the payer segment in Medicare Advantage, Managed Medicaid, or with an industry competitor
Experience performing and documenting quality reviews of healthcare transactions
Experience with coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures
Experience with MS PowerPoint, MS Word, MS Excel, and MS Access
Attention to detail and ability to work under time constraints
Exceptional interpersonal, listening, written, and oral communication abilities
Ability to comply with company security and privacy policies and applicable laws and regulations, including HIPAA and HITECH
Ability to safeguard PHI and PII securely
Experience in a BPaas environment is a plus
Experience reviewing system configuration is a plus

Benefits

Comp & perks

100% remote work culture
Health, dental & vision insurance
5 weeks' vacation and holiday pay
Traditional and ROTH 401k with company match
Company paid life insurance, AD&D, and long-term disability coverage
HSA and FSA accounts
Tuition Reimbursement
Parental Leave