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Insurance Quality Assurance Remote Jobs in Tennessee

LabConnect

Senior Quality Specialist

Johnson City, TN · On-site +1

$79K - $109K/yr

Provide industry leading QMS compliance guidance and quality assurance consultation to internal and ... Short and Long-Term Disability, Life Insurance, and AD&D * We celebrate our differences, which ...

Premise Health

Quality Engineer - Remote

Brentwood, TN · On-site +1

$50K - $57K/yr

A minimum of 3 years of experience in Quality Engineering / Quality Assurance for IT solutions * A ... insurance, a 401(k) program with company match, paid holidays and vacation time, a company ...

Empire State Careers

Remote Insurance Agent

Knoxville, TN · Remote

$69K - $150K/yr

Remote Insurance Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

Altegra Health

Remote Certified Coders

Memphis, TN · Remote

$21.75 - $29.75/hr

Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ... Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk ...

Empire State Careers

Remote Insurance Agent

Memphis, TN · Remote

$69K - $150K/yr

Remote Insurance Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

HMG Careers

Remote Insurance Agent

Jackson, TN · Remote

$69K/yr

Remote Insurance Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

Empire State Careers

Remote Insurance Agent

Nashville, TN · Remote

$69K - $150K/yr

Remote Insurance Representative | Flexible Schedule | Commission-Based This position offers ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

Lone Star Careers

Remote Insurance Agent

Knoxville, TN · Remote

$69K - $150K/yr

Remote Insurance Representative | Flexible Schedule | Commission Only This position offers flexible ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

Lone Star Careers

Remote Insurance Agent

Nashville, TN · Remote

$69K - $150K/yr

Remote Insurance Representative | Flexible Schedule | Commission Only This position offers flexible ... High-quality leads provided with no cold calling friends or family * Flexible scheduling within a ...

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Insurance Quality Assurance Remote information

What is an insurance quality assurance remote?

An Insurance Quality Assurance Remote job involves evaluating and monitoring insurance processes, documents, and interactions to ensure they meet company standards and regulatory requirements—all while working from a remote location. Professionals in this role review claims, policies, and customer interactions to identify errors, ensure compliance, and recommend improvements. They often work closely with other remote teams to maintain high-quality service and prevent costly mistakes. Strong attention to detail, analytical skills, and knowledge of insurance regulations are essential for success in this position.

What are the key skills and qualifications needed to thrive as an insurance quality assurance remote professional?

To thrive as an Insurance Quality Assurance Remote professional, you need a solid understanding of insurance processes, quality control standards, and a relevant degree or background in insurance or auditing. Familiarity with claims management systems, quality assurance tools, and industry certifications such as Six Sigma or ISO are commonly required. Attention to detail, analytical thinking, and effective written communication are essential soft skills for identifying discrepancies and collaborating with remote teams. These competencies ensure consistent compliance, accuracy, and high-quality service delivery in a remote insurance environment.

What are some common challenges faced by remote insurance quality assurance professionals, and how can they be addressed?

Remote Insurance Quality Assurance professionals often face challenges such as limited direct communication with team members, staying updated on policy changes, and maintaining consistency in audit standards. To address these, it's important to leverage collaboration tools, participate in regular virtual meetings, and establish clear documentation protocols. Building strong relationships with claims adjusters and underwriters remotely also helps ensure quality standards are met and feedback is effectively shared.

What is the difference between Insurance Quality Assurance Remote vs Insurance Claims Examiner?

AspectInsurance Quality Assurance RemoteInsurance Claims Examiner
Required CredentialsCertifications in quality assurance, insurance industry knowledgeAdjuster licenses, insurance certifications
Work EnvironmentRemote, office-based, or hybridRemote or in-office claims processing
Industry UsageUsed across insurance companies for process improvementUsed by insurance companies to evaluate claims
Common Search IntentQuality assurance roles in insurance, remote QA jobsClaims processing jobs, insurance examiner roles

Insurance Quality Assurance Remote and Insurance Claims Examiner roles both operate within the insurance industry but focus on different aspects. QA roles emphasize process improvement and compliance, often remotely, while Claims Examiners evaluate individual claims, which may also be remote. Understanding these differences helps job seekers find the right position aligned with their skills and career goals.

What are the most commonly searched types of Insurance Quality Assurance jobs in Tennessee?

The most popular types of Insurance Quality Assurance jobs in Tennessee are:

What are popular job titles related to Insurance Quality Assurance Remote jobs in Tennessee?

For Insurance Quality Assurance Remote jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Insurance Quality Assurance Remote jobs in Tennessee look for?

The top searched job categories for Insurance Quality Assurance Remote jobs in Tennessee are:

What cities in Tennessee are hiring for Insurance Quality Assurance Remote jobs?

Cities in Tennessee with the most Insurance Quality Assurance Remote job openings:

Insurance Quality Assurance Remote jobs near you
Infographic showing various Insurance Quality Assurance Remote job openings in Tennessee as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 22% Part Time, and 4% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Coding Quality Assurance (QA) Manager, Remote

Aledade PBC

Nashville, TN • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago

Job description

As a Coding Quality Assurance (QA) Manager, you will lead a high-performing team of QA Specialists at the intersection of clinical precision and operational excellence. You'll drive coding accuracy, build robust Standard Operating Procedures (SOPs), and ensure full audit readiness by evaluating documentation from both our internal CDI team and external partners. If you bring deep expertise in Risk Adjustment and Hierarchical Condition Categories (HCC) alongside a passion for mentoring talent and elevating compliance standards, this role offers a direct platform to shape our quality operations and make a measurable impact.
 
Candidates should be comfortable working remotely from anywhere within the US, across all US time zones.
Primary Duties
  • Team Leadership & Oversight: Lead, mentor, and manage a team of  QA Specialists. Establish team goals, monitor productivity, conduct regular performance reviews, and foster a culture of continuous learning.
  • Quality Audits: Oversee and perform comprehensive quality assurance reviews for coding completed by internal CDI staff and external vendor partners, ensuring compliance with official ICD-10-CM guidelines and risk adjustment models.
  • SOP & Guideline Development: Design, implement, and maintain standard operating procedures, audit workflows, scoring methodologies, and coding quality guidelines across the organization.
  • Payer Audit Support: Act as a key subject matter expert (SME) during external payer audits (e.g., RADV, Medicare, Commercial). Assist with chart selection, review, dispute documentation, and appeal responses.
  • Vendor Management: Evaluate third-party coding vendor accuracy rates against established SLAs. Deliver constructive feedback, identify trend errors, and drive corrective action plans when necessary.
  • Education & Feedback Loops: Translate QA audit findings into actionable insights. Provide structured feedback and target educational resources to internal CDI specialists and vendors to prevent recurring errors.
  • Other duties as assigned
Minimum Qualifications:
  • Bachelor's Degree in health care management, nursing or related field or an Associate Degree with relevant experience in CDI, coding, coding management, or HCC Risk Adjustment required.
  • Minimum of 4 years of HCC coding experience with 2 years specifically focused on coding quality assurance, auditing, or compliance monitoring.
  • Active professional credentials from AAPC and/or AHIMA required (such as CRC, CCS, CPC, or CPMA).
  • Deep mastery of ICD-10-CM coding, CMS Risk Adjustment guidelines, RADV audit rules, and clinical documentation requirements.
Preferred KSA's:
  • CRC (Certified Risk Adjustment Coder)
  • Experience working within Value-Based Care (VBC) models, ACOs, or Advantage plans.
  • Prior experience managing small teams or leading vendor oversight programs.
  • Exceptional leadership, communication, and organizational skills.
  • Proficiency with EHR systems and encoder software
Who We Are:
Aledade PBC, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
 
What Does This Mean for You?
At Aledade PBC, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
 
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
 
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!
 
At Aledade PBC, we don't just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
 
 
We may use automated tools, including artificial intelligence (AI), to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. Human judgment plays an essential role in our hiring process, including in the oversight and use of any automated tools. If you would like more information about our screening and hiring process, please contact us. Our Commitment to Authenticity. We use Endorsed, a fraud detection tool, to validate the authenticity of applications and protect against identity fraud. This ensures we are connecting with real people and allows us to prioritize genuine candidates. When you apply to a job on this site, the personal data contained in your application will be collected by Aledade PBC using Lever, a cloud services provider located in the United States. Lever is engaged by Aledade PBC to help manage its recruitment and hiring processes. For more information about how your personal data will be processed by Aledade PBC and any rights you may have, please review Aledade PBC's Candidate Privacy Notice. By applying for this job, you agree to Aledade's Applicant Privacy Policy available at https://www.aledade.com/privacy-policy-applicants If you have any questions about our privacy practices, please contact [email protected].
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