Description: ??Acts as an Advocate for, and support, the business by serving as a quality champion ??Performs routine quality audits for network operations and claim testing ??Conduct standard quality reviews /audits to measure compliance with published policies ??Identify and distribute errors to business partners ??Support the design and development of new processes ??Analyze and resolve complex claims scenarios within established time frames ??Respond to and resolves customer inquiries and complaints (internal as well as external) ??Analyzes and recommends solutions to non-standard requests and requirements from plan sponsors. Requirements: ??1-2+ years work experience in the audit environment that reflects a proven track record or proficiency in the competencies noted. ??Experience with claims testing, and a working knowledge of PPO??. ??Experience with DG system. Benefits: ??Affordable medical plan options ??401(k) plan (including matching company contributions) ??Employee stock purchase plan ??No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. ??Paid time off ??Flexible work schedules ??Family leave ??Dependent care resources ??Colleague assistance programs ??Tuition assistance ??Retiree medical access ??Many other benefits depending on eligibility.