Quality Control Analyst Remote Jobs in Portland, OR

Let’s do great things, together!

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Summary
The Medical Provider Configuration Analyst I is responsible for performing configuration activities, assisting in research and resolution of configuration issues, and supporting system testing and projects. This position focuses on learning and applying provider configuration principles in Facets or similar systems. This is a FT WFH position.

Pay Range
$23.34 - $26.26 hourly (depending on experience)
*Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range

Please fill out an application on our company page, linked below, to be considered for this position.

https://j.brt.mv/jb.do?reqGK=27779167&refresh=true
 

Benefits:

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays

Required Skills, Experience & Education:

1. Bachelor's degree or equivalent combination of education and experience.
2. 0-2 years of experience in health insurance or a related field.
3. Proficient in Microsoft Office, especially Excel; eagerness to learn advanced Excel functions for data analysis.
4. Basic SQL knowledge.
5. Basic knowledge of healthcare provider data and claims processing preferred.
6. Strong analytical and critical thinking skills with the ability to apply business rules to configuration tasks.
7. Basic understanding of data integrity and quality assurance practices.
8. Ability to follow standards for data validation and spreadsheet preparation.
9. Strong attention to detail, organizational skills, and ability to manage multiple priorities effectively.
10. Ability to learn new concepts quickly and adapt to changing processes.
11. Good written and verbal communication skills.
12. Ability to work well in a remote team environment.
13. Maintain a professional appearance and demeanor in all internal and external interactions.

Primary Functions:

1. Analyze and configure provider information in the system following established procedures and business rules.
2. Perform data analysis and validation using Excel, including formulas, data sorting and VLOOKUP functions.
3. Prepare and validate provider rosters for Robotic Automation System (RAS) processing.
4. Identify and resolve provider configuration errors using SQL.
5. Report data issues to the lead or supervisor.
6. Participate in projects with guidance from senior team members.
7. Assist in documenting configuration processes and updating department manuals.
8. Conduct quality reviews of configuration work and submit for timely auditing.
9. Attend training to improve skills and knowledge.
10. Follow quality standards and help with quality checks.
11. Perform other duties as assigned.

Together, we can be more. We can be better.
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Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. 
For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.