MagnaCare is seeking experienced Quality Control Auditors to conduct call evaluations and audits on claims, enrollments, eligibility, and provider data to ensure compliance with contractual agreements and Labor fund policies.
Primary Responsibilities
Perform detailed audits of claims adjudication, eligibility processing, and customer service calls and walk-ins.
Identify system configuration and manual processing errors.
Provide error analysis reports and recommendations for corrective actions.
Essential Qualifications
Minimum 3 years of quality control or auditing experience in TPA or Labor health plans.
Knowledge of claims processing, eligibility rules, and provider agreements.
Strong analytical and problem-solving skills.
Bilingual Spanish preferred.
At MagnaCare LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect, and increasing diversity, inclusion, and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all your unique abilities.
For more than 30 years, MagnaCare LLC has been a trusted partner in delivering flexible, customized solutions for self-insured organizations. As a national third-party administrator (TPA), we combine proprietary technology, network expertise, and a deep understanding of labor to help our clients achieve their goals while supporting the people they serve.
Our focus on labor means we work closely with funds, Taft-Hartley Trusts, and other self-insured groups to deliver tailored solutions that go beyond the basics. From health plan administration and eligibility management to contribution accounting, we provide the tools and support organizations need to succeed. With specialized offerings such as flexible network administration, direct contracting, in-house medical and care management, and workers’ compensation programs, we create benefit plans that address unique needs with precision.
