Claims Quality Auditor audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Being a Claims Quality Auditor makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Additionally, Claims Quality Auditor typically reports to a supervisor or a manager. The Claims Quality Auditor gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Claims Quality Auditor typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Job Summary
The Quality Auditor is responsible for management of the project Quality audit schedule and performing Quality audits per the approved schedule. They are also responsible for management of project Quality systems and reporting of project Quality metrics.
Responsibilities
Required Qualifications
Preferred Qualifications