Quality Assurance Specialist, Medical Claims

Job overview

The Quality Assurance Specialist, Medical Claims role is onsite in Exeter, NH, with a stated salary of $45,000–$51,000 per year. Cobalt Benefits Group administers self-funded employee benefit plans and supports clients through claims and related programs. The role helps ensure accurate medical claims and benefit administration through daily audits, error analysis, and quality oversight. It supports operational excellence by documenting findings, recommending corrective actions, and collaborating with claims and service teams to resolve issues.

What you'll do

• Conduct daily pre-pay and post-pay medical claims audits
• validate benefit application, provider network tiering, and reimbursement
• verify claims against provider contracts, fee schedules, and plan designs
• document and communicate errors and trends
• conduct production, system configuration, and operational quality audits
• complete LDLA and MTM reviews
• support client, regulatory, and internal audits
• participate in client and plan-change testing
• produce reports and recommend corrective actions
• collaborate with related teams to resolve quality issues.

What we're looking for

Skills & competencies

quality assurance specialist

medical claims

exeter nh

cobalt benefits group

full-time

$45k–$51k/year

claims auditing

benefit administration

provider network tiering

quality oversight

self-funded health plans

audit reporting

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical, dental, and vision insurance
• employer HSA contributions
• basic life and AD&D
• short- and long-term disability
• flexible spending accounts
• 401(k) with up to 6% employer match
• paid holidays, vacation, and sick time
• paid volunteer day
• tuition and wellness reimbursements.

Why this role

Audits medical claims across benefit application, provider network tiering, contract pricing, and operational quality.

About the employer

Cobalt Benefits Group LLC is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.