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)
Home Based, US
The Quality Assurance (QA) Auditor II will have experience and knowledge of appropriate GxP compliance and other applicable regulations and laws, Parexel procedures and appropriate Parexel processes, which allows the individual to plan and conduct internal and external audits independently, or with minimal supervision. Provide advice on regulatory compliance, with appropriate supervision. Stong background in GCP auditing strongly preferred.
Accountabilities:Perform and Report audits
Follow-up audits
Support auditor training
Billable Audits & Client Relationships (where applicable)
Support Client Audits and Regulatory Inspections
Maintain sound knowledge of Parexel policies, procedures, and guidelines
Build and maintain relationships
Education
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0 Claims Quality Auditor jobs found in Lowell, MA area