Quality Audit Analyst (Health Insurance)

Location: Helena, Montana, United States; hybrid schedule with 3 days in the office and 2 days remote

Base pay: $41,700–$92,800 annually, plus eligibility for an annual incentive bonus.

Company

hirify.global is a purpose-driven health insurance organization that invests in employee development and career growth.

What you will do

• Plan and conduct detailed quality and performance audits.
• Review claims, inquiries, memberships, and other business transactions.
• Assess compliance with internal controls and Model Audit Rule requirements.
• Verify that processing is timely, accurate, complete, and performed in the appropriate systems.
• Analyze programs, processes, and audit findings while meeting defined deadlines.

Requirements

• Bachelor’s degree and 2 years of experience auditing claims, inquiries, or memberships in the health insurance industry, or 6 years of relevant audit experience.
• Knowledge of Blue Chip processing systems such as BlueSTAR and CFE, contract administration, and medical terminology.
• Analytical, research, written communication, verbal communication, organizational, and multitasking skills.
• Knowledge of state contract provisions and departmental documentation.
• PC proficiency, including Word, Excel, PowerPoint, EPPS, NICE, Live Meeting/WebEx, and Lotus Notes.
• Demonstrated ability to meet deadlines.

Nice to have

• Quality audit experience.
• Knowledge of health insurance products.

Culture & Benefits

• Curated development plans and professional development support.
• Health and wellness benefits.
• 401(k) savings plan and pension plan.
• Paid time off, paid parental leave, paid holidays, and disability insurance.
• Supplemental life insurance, employee assistance program, tuition reimbursement, and other incentives.