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)
Designs for Health, Inc.
Designs for Health is an industry-leading and rapidly growing manufacturer and distributor of nutritional supplements offered primarily through health care practitioners. By providing comprehensive support through our extensive product line, ongoing clinical education, and practice development programs, Designs for Health helps practitioners realize successful health outcomes for their patients. The company has two manufacturing plants and four distribution centers in the United States, and its products are distributed in five continents.
Position Overview
Quality Auditors inspect processing equipment and ensure that employees are performing their jobs correctly and following company procedures and safety rules. The Auditor reviews and analyzes quality inspection data to find specific types of quality problems the department or company is experiencing. The Auditor provides information on the particular defects that can be addressed. An Auditor writes and implements test and inspection procedures to obtain the defect information needed for analysis, and report findings from test and inspection data to management. They participate in employee quality improvement teams to reduce defects and quality issues, and make recommendations to improve the production process based on findings from auditing analysis. The Auditor monitors the procedure to determine if changes significantly improve the process and defect quantities. Quality Auditors document results of new procedures after implementation to show quality improvements. Auditors must be familiar with quality assurance principles, inspection techniques and testing procedures. Quality Auditors must have good verbal and written communication skills to present findings from data analysis. Auditors must have computer skills and familiarity with issue tracking software programs.
3rd shift
Essential Job Functions
Requirements
Benefits
Designs for Health offers a competitive compensation and benefits package:
Privacy
Your application for this position is subject to Designs for Health's Privacy Notice for Job Applicants and Workforce Members. Designs for Health does not sell your personal information, nor does Designs for Health share it for purposes of cross-context behavioral advertising.
Our Commitment to Diversity, Inclusion & Belonging
Designs for Health is an equal opportunity employer. We welcome diversity and are committed to creating an inclusive environment where all employees can grow and thrive. Our employees form meaningful and often life-long connections while working at Designs for Health. We are all passionate about our mission of designing a well world, together.
Clear All
0 Claims Quality Auditor jobs found in Las Vegas, NV area