Quality Assurance Spec
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Before you apply
Salary$48k – $67k
LocationLee's Summit, MO
Work moderemote · United States
Typefull-time
SeniorityMid
Experience4+ yrs
Company size14+ people
PostedOct 6, 2026 · 1mo ago
Verified live1d ago
At a glanceSummarised by Seekless from the posting.
Associate's degree (or additional experience in lieu of degree)
4 years of related experience
Effective written and verbal communication skills
Proficiency with MS Word and MS Excel
Thorough knowledge of Provider Data Management policy and procedures
Experience as an Associate Quality Assurance Specialist within PDM
Must reside in Kansas City Metro
Ability to provide non-cellular high speed internet with minimum 30x5 Mbps speed and latency below 80 ms
Dedicated space lacking ongoing interruptions to protect PHI/HIPAA information
Skills
MS Word
MS Excel
Benefits
Health insurance
Dental insurance
Vision insurance
401(k)
Life insurance
Disability insurance
Tuition assistance
Paid time off
About the company
Government Employees Health Association, Inc. (G.E.H.A) is a nonprofit member association that provides health and dental benefits that millions of federal employees and retirees, military retirees and their families have counted on since 1937. Offering one of the largest health and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care.
G.E.H.A has one mission: To empower federal workers to be healthy and well.
About the role
The Quality Assurance Specialist audits claims coding, customer service calls or electronic files for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures.
SKILLS
Duties and Responsibilities:
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Updates and completes daily, monthly, and annual reports.
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Prepares responses to correspondence and manages complex provider issues and calls.
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Answers questions from PDM staff and other departments regarding provider updates and issues.
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Makes recommendations to improve quality, workflow processes, policies, and procedures.
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Credentialing:
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Chairperson
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SAL Audit
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VP Files (CVO Initial & CVO Re-Creds)
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WAP Audit
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OGM Invalid License
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IH Initial & Re-Creds
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Cred Verification
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MS Review Audit
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Contract Audit
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Provider Verification:
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Provider Relations:
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Call Audits
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Service Issue Audit
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Case Audit
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Audit Errors
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Assists with department training.
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Contributes independently and collaboratively across departments and cross-functional projects.
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Analyzes audit reports and rebuttals to identify trends and recommend determination of outcome.
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Reviews and makes suggestions for changes/updates to training materials and existing desk-level procedures and policies.
Knowledge, Skills, and Abilities:
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Requires an associate’s degree. Will consider additional experience in lieu of degree.
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Requires 4 years of related experience.
•
Requires effective written and verbal communication skills to answer questions from staff and providers.
•
Requires proficiency with MS Word and MS Excel.
•
Must have thorough knowledge of Provider Data Management policy and procedures.
Preferred Qualifications
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Experience as an Associate Quality Assurance Specialist within PDM.
Must Reside in Kansas City Metro
Work-at-home requirements
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Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
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A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
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Latency (ping) response time lower than 80 ms
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Hotspots, satellite and wireless internet service is NOT allowed for this role.
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A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
How we value you
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Competitive pay/salary ranges
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Incentive plan
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Health/Vision/Dental benefits effective day one
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401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
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Robust employee well-being program
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Paid Time Off
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Personal Community Enrichment Time
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Company-provided Basic Life and AD&D
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Company-provided Short-Term & Long-Term Disability
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Tuition Assistance Program
While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.
Please note that the salary information is a general guideline only. G.E.H.A considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.
The target hiring range for this position is $47,808 - $60,480 USD. At G.E.H.A, the current maximum salary for this role is $67,392 USD. While initial compensation may vary based on experience and qualifications, there is a path to work toward this top rate through performance and continued growth within the organization.
Legal
G.E.H.A is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. G.E.H.A will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees.
G.E.H.A is headquartered in Lee’s Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.