Claims Quality Auditor jobs in Omaha, NE

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)

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Claims/QC Auditor
  • Chubb INA Holdings Inc.
  • Omaha, NE FULL_TIME
  • Audit claims to assure accurate and timely payment and to test the work product of claims adjusters.

    Essential Job Duties and Responsibilities:
    Performs claims auditing functions, including but not limited to:

    Opening claims, assigning claim numbers, entering claims data into computer, etc. in a timely manner.

    Checking losses to ensure that all supporting documentation is included and auditing claims according to established guidelines.

    Entering loss information on computer system.

    Confirming accuracy of information against error listings and corrects errors.

    Referring problem files to appropriate supervisor or manager.

    Answer questions from adjusters, agents, field staff, and insures about claim status and procedures.

    Generating and distributing various reports, such as claim forms, claim progress reports, and loss drafts.

    Performs various quality control functions, including but not limited to:

    Generating quality control documents, reports and distributing as directed.

    Entering completed quality control reviews on computer system.

    Informing appropriate staff of the review process and results.

    Making changes in policies as necessary to reflect QC audit results.

    Maintaining records of agent and adjuster training hours as necessary.

    Assist with other duties as necessary.

    Qualifications
    High School or GED required and at least 6 months as an Claims/QC Assistant at Rain and Hail or at least one year of previous underwriting or claims auditing experience or a baccalaureate degree.

    Knowledge, Skills, and Abilities:
    Ability to learn and apply detailed information about the Company’s products, services, processes and systems.

    Ability to organize and prioritize multiple tasks.

    Ability to work in a team oriented environment.

    Ability to effectively communicate and maintain business relationships with Company personnel, outside resources and customers.

    Ability to comprehend agents’ questions and concerns with regard to claims and to provide correct, courteous answers.

    Ability to learn and use the company’s terminology, procedures and systems.

    Ability to learn and develop skills in the use of department equipment.

    Ability to perform basic and complex mathematical calculations.

    Ability to remain calm and professional during peak periods of activity.

    Ability to work from oral and written communication.

    Ability to maintain confidentiality.

    Ability to assist in other work-related areas as required.

    EEO Statement
    At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion,and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin,ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law.Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliationagainst any individual who reports discrimination or harassment.
  • 10 Days Ago

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Auditor
  • Artech LLC
  • Elkhorn, NE FULL_TIME
  • AUDITOR ELKHORN, NE Mon-Friday- 7-3:30pm The pay for this position is $20 per hour. Required Skills: HS Diploma or equivalent required. Analytical, scientific, and mechanical trouble shooting skills. ...
  • 10 Days Ago

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Claims Examiner
  • Markel Service Inc.
  • Omaha, NE FULL_TIME
  • What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize oppor...
  • 20 Days Ago

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Claims Representative
  • TEKsystems
  • Omaha, NE FULL_TIME
  • Description: Regularly answer calls in a timely, positive manner and provide exceptional customer service Receive inbound calls from claimants, attorneys, vendors, brokers and third party Administrato...
  • 1 Day Ago

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Claims Processor
  • Alutiiq
  • Bellevue, NE FULL_TIME
  • We are looking for a detail-oriented person to join the OxBow Team. You will be responsible for reviewing claims, matching them with existing clients or enrolling new clients as needed and working clo...
  • 11 Days Ago

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Claims Analyst
  • Physicians Mutual
  • Omaha, NE FULL_TIME
  • Physicians Mutual is hiring for a full time Claims Analyst to review and analyze multiple source claim documents and correspondence to determine proper processing. What you will do in this role: Ident...
  • 13 Days Ago

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0 Claims Quality Auditor jobs found in Omaha, NE area

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Project Accountant III
  • AECOM
  • Omaha, NE
  • Company Description Work with Us. Change the World. At AECOM, we're delivering a better world. Whether improving your co...
  • 3/29/2024 12:00:00 AM

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Housekeeping Manager
  • Homewood Suites Omaha Downtown
  • Omaha, NE
  • Overview: Opportunity: Housekeeping Manager Manage housekeeping operations in accordance with established guest service,...
  • 3/29/2024 12:00:00 AM

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Project Construction Assistant Manager
  • AA2IT
  • Omaha, NE
  • Job Description Job Description Title - Associate Construction Manager Location - Omaha, NE Duration - 12 months Pay Rat...
  • 3/29/2024 12:00:00 AM

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Quality Engineer
  • Client Resources, Inc.
  • Omaha, NE
  • This candidate will be responsible for the development, implementation, maintenance, and improvement of quality assuranc...
  • 3/28/2024 12:00:00 AM

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Quality Engineer
  • Client Resources Inc.
  • Omaha, NE
  • This candidate will be responsible for the development, implementation, maintenance, and improvement of quality assuranc...
  • 3/28/2024 12:00:00 AM

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Executive Sous Chef II
  • Atrium Hospitality
  • La Vista, NE
  • Hotel: La Vista Embassy Suites Executive Sous Chef II Full time Atrium SPIRIT - where teamwork, passion and appreciation...
  • 3/28/2024 12:00:00 AM

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Clinical Research Coordinator
  • Quality Clinical Research,
  • Omaha, NE
  • Job Description Job Description Quality Clinical Research is a dynamic and innovative research organization dedicated to...
  • 3/27/2024 12:00:00 AM

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Route Trainee - UniFirst
  • UniFirst
  • OMAHA, NE
  • UniFirst is seeking a driven customer focused Route Trainee to join the UniFirst team. As a Route Trainee, you will supp...
  • 3/14/2024 12:00:00 AM

Omaha (/ˈoʊməhɑː/ OH-mə-hah) is the largest city in the state of Nebraska and the county seat of Douglas County. Omaha is located in the Midwestern United States on the Missouri River, about 10 miles (15 km) north of the mouth of the Platte River. The nation's 40th-largest city, Omaha's 2018 estimated population was 466,061. Omaha is the anchor of the eight-county, bi-state Omaha-Council Bluffs metropolitan area. The Omaha Metropolitan Area is the 59th largest in the United States, with an estimated population of 944,316 (2018). The Omaha-Council Bluffs-Fremont, NE-IA Combined Statistical Are...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$43,356 to $53,143
Omaha, Nebraska area prices
were up 0.8% from a year ago

Claims Quality Auditor in Bloomington, IN
Evaluates claims activities of other departments and / or companies.
December 05, 2019