Claims Quality Audit Supervisor supervises and coordinates daily activities of claims quality auditors. Provides assistance in developing claims audit policies and procedures. Being a Claims Quality Audit Supervisor solves day-to-day problems and monitors the results of daily staff activities, reports critical issues and problems to the management. Typically requires a bachelor's degree. Additionally, Claims Quality Audit Supervisor typically reports to a manager. The Claims Quality Audit Supervisor supervises a group of primarily para-professional level staffs. May also be a level above a supervisor within high volume administrative/ production environments. Makes day-to-day decisions within or for a group/small department. Has some authority for personnel actions. Thorough knowledge of department processes. To be a Claims Quality Audit Supervisor typically requires 3-5 years experience in the related area as an individual contributor. (Copyright 2024 Salary.com)
Weekends are mandatory
Position Summary:
Responsible for supervision of the Revenue Auditors and for ensuring compliance of department policies and procedures in accordance with Company, State and Federal regulations and internal controls.
Essential Responsibilities: A review of this description has excluded the marginal functions of this job which are incidental to the performance of fundamental job duties. All duties or requirements are essential job functions. This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be expected to follow any other job-related instruction and to perform any other job-related duties requested by their supervisor. This document does not create an employment contract, implied or otherwise, other than an “at-will” employment relationship.
1. Maintains confidentiality of all privileged information in accordance with established Company
Policy, State and Federal regulations.
2. Provides next-level guest service to internal and external guests.
3. Responsible for creating and fostering an environment of support and motivation for team members.
4. Hires, motivates, trains, coaches, mentors, and directs staff to ensure that Team Members receive leadership, guidance and resources to accomplish established objectives.
5. Establishes department standards, guidelines and objectives, and maintains other administrative pro- cesses such as budget and staffing to ensure proper planning and efficient operation of assigned areas.
6. Maintains confidentiality of all privileged information in accordance with established procedures with company policy and state regulations.
7. Adheres to all Internal Control Policies and Procedures, Bank Secrecy Act, Title 31 Rules and Regu- lations, and ensures company accounting procedures and reporting conform to Generally Accepted
Accounting Principles (GAAP).
8. Audits the departments as required. Includes audit of department’s paperwork to ensure compliance with Company policies and procedures, State Federal and State laws and regulations.
9. Issues exception reports for violations of company policies and procedures, New Hampshire Lottery
Commission regulations and Federal and State laws.
10. Oversees and analyzes journal entries for departments as required.
11. Analyzes and creates spreadsheets, complies with all company policies and procedures, New Hamp- shire Lottery Commission regulations and Federal and State laws.
12. Resolves problems that are within the position's scope of authority and recommends courses of action to resolve problems that are beyond the scope of authority to the position’s supervisor. Keeps posi- tion supervisor informed of relevant activities.
13. Reviews the work activities of subordinate employees to ensure that work is being performed within the standards established by management.
14. Ensures compliance with Internal Control Policies and Procedures. Adheres to regulatory, departmental, and company policies in an ethical manner.
15. Attend required training sessions offered by the Company.
16. Perform the duties described in compliance with local laws and regulations.
17. Have knowledge of the ordinances, regulations, laws, policies, and procedures relating to the team member’s department.
18. Take on and manage various projects as assigned in order to aid in achievement of evolving Company goals and objectives.
19. Take the necessary steps to ensure minors are not allowed to gamble or loiter in gambling areas, drink alcoholic beverages, or purchase tobacco.
20. Have knowledge of the ordinances, regulations, laws, policies, and procedures relating to the Team
Member’s department.
21. Have knowledge of the Property’s programs to address problem gaming.
22. Report any acts of wrongdoing of which the Team Member may have knowledge.
23. Other duties as assigned.
Position Qualifications:
Work Environment & Physical Demands: This job operates in a professional office environment.
This role routinely uses standard office equipment such as computers, phones, photocopiers, scanners, filing cabinets and fax machines.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.
·This position requires the ability to occasionally lift office products and supplies, up to 20 pounds.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.
Job Type: Full-time
Pay: From $50,000.00 per year
Benefits:
Experience:
Ability to Commute:
Work Location: In person