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)
Must possess appropriate mathematical and analytical skills to determine acceptability of product(s) based on established criteriaSelf-motivated with the ability to self-manage (set and achieve goals) and work with limited supervision.
Organizational skills with attention to detailLeveraging an ever-expanding, interconnected group of people from diverse backgrounds, Pro QC offers an attractive and unique opportunity as part of a global family.
To nurture the trust of our customers and our team through dynamic interactions, creative supply chain solutions, and integrated partnership.
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0 Claims Quality Auditor jobs found in Lincoln, NE area