Claims Quality Auditor jobs in Trenton, NJ

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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Auditor
  • VERUS CLAIMS SERVICES LLC
  • Princeton, NJ FULL_TIME
  • Description

    SUMMARY

    The Claims Auditor is responsible for testing and evaluating the audits, ensuring compliance with pre-established Procedures, Agreements, and Audit Protocol. In addition, the Claims Auditor is equally responsible for administrative tasks outside the audit queues assigned by the Audit Supervisor. The Claims Auditor should have knowledge of commonly-used concepts, practices, and audit procedures. Works under immediate supervision in a collaborative team environment.


    PRIMARY RESPONSIBILITIES

    • Review and evaluation of claims identified for audit to ensure accuracy, completeness and eligibility for compensation.
    • Summarize and analyze audit findings.
    • Assist in the preparation of the monthly reports to Trusts.
    • Prepare memorandums, letters, and other written communication.
    • Perform any other additional ad-hoc tasks (i.e. Trustee/Trust Counsel requests, follow up on outstanding audits, communication with law firms, maintaining internal logs and meeting notes, work related to annual external audits, etc.) as necessary.
    • Assists with updating of processes and procedures.


    Requirements

    KNOWLEDGE AND SKILL REQUIREMENTS/COMPETENCIES

    • Minimum of 2 years audit related work experience.
    • Prior experience with Settlement Administration Trusts and/or healthcare industry is a plus.
    • Adaptability to changing policies, procedures, and systems.
    • Strong attention to detail.
    • Ability to multitask, work to deadlines, and be proactive.
    • Strong problem-solving, critical thinking, and analytical skills.
    • Ability to work collaboratively with team members.
    • Effective communication skills, both verbal and written.
    • Proficient in Microsoft Word and Excel.
  • 2 Days Ago

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Quality Control Analyst
  • VERUS CLAIMS SERVICES LLC
  • Princeton, NJ FULL_TIME
  • DescriptionThe Quality Control Analyst is responsible for performance of quality control procedures and ensuring compliance with required procedures. Has knowledge of commonly-used quality control con...
  • 8 Days Ago

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Claims Reviewer
  • VERUS CLAIMS SERVICES LLC
  • Princeton, NJ FULL_TIME
  • DescriptionVerus Claims Reviewers are responsible for first review and data capture for all types of submitted documentation related to current case management and settlement administration projects. ...
  • 18 Days Ago

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Quality Coordinator / Internal Auditor
  • Interstate Connecting Components
  • Lumberton, NJ FULL_TIME
  • JOB SUMMARY Coordinates and supports quality assurance processes, initiatives, continuous improvement efforts and customer fulfillment. Assists operations and quality management to ensure process cont...
  • 3 Days Ago

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Quality Auditor II - RN
  • Healthcare Support Staffing
  • Trenton, NJ FULL_TIME
  • Company DescriptionHealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare profe...
  • 11 Days Ago

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Senior Accountant
  • VERUS CLAIMS SERVICES LLC
  • Princeton, NJ FULL_TIME
  • DescriptionSUMMARYThe Senior Accountant analyzes financial information and prepares financial reports to determine or maintain record of assets, liabilities, profit and loss, tax liability or other fi...
  • 18 Days Ago

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0 Claims Quality Auditor jobs found in Trenton, NJ area

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Manager Quality Food Safety Co Manufacturers
  • The Judge Group
  • Horsham, PA
  • Manager Quality Food Safety Co Manufacturersreq37250Employment Type: RegularLocation: HORSHAM,PAHave you ever enjoyed Ar...
  • 3/28/2024 12:00:00 AM

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Manufacturing Quality Manager
  • Dexian - DISYS
  • New Brunswick, NJ
  • Title- Manufacturing Quality Manager Duration- 12+ months Location- New Brunswick, NJ Pay range- $44 to $46/hr Job Funct...
  • 3/28/2024 12:00:00 AM

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Manager, Clinical Quality Assurance
  • Terumo Medical
  • Somerset, NJ
  • Job Description Job Description Job Summary: Hybrid in Somerset, NJ or Elkton, MD The Manager of Clinical Quality Assura...
  • 3/27/2024 12:00:00 AM

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Quality Control Auditor
  • Ram Associates
  • Trenton, NJ
  • Job Description Job Description Job requirements include: - Review of financial statements and audit attestations to ens...
  • 3/27/2024 12:00:00 AM

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QC Scientist - Testing Services
  • GenScript
  • Piscataway, NJ
  • About GenScript GenScript Biotech Corporation (Stock Code: 1548.HK) is a global biotechnology group. Founded in 2002, Ge...
  • 3/27/2024 12:00:00 AM

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Production Manager
  • Penn Life Sciences
  • Langhorne, PA
  • Job Description Job Description Department Manufacturing Job Title Production Manager FLSA Status Exempt Reports To Dire...
  • 3/26/2024 12:00:00 AM

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Manufacturing Quality Manager
  • Dexian
  • New Brunswick, NJ
  • Title- Manufacturing Quality Manager Duration- 12+ months Location- New Brunswick, NJ Pay range- $44 to $46/hr Job Funct...
  • 3/25/2024 12:00:00 AM

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Director of Quality and Safety
  • New Jersey Manufacturing Extension Program
  • Burlington, NJ
  • Job Description Job Description The Director of Quality and Safety will act as the primary liaison for comprehensive qua...
  • 3/24/2024 12:00:00 AM

According to the United States Census Bureau, the city had a total area of 8.155 square miles (21.122 km2), including 7.648 square miles (19.809 km2) of land and 0.507 square mile (1.313 km2) of water (6.21%). Several bridges across the Delaware River – the Trenton–Morrisville Toll Bridge, Lower Trenton Bridge and Calhoun Street Bridge – connect Trenton to Morrisville, Pennsylvania, all of which are operated by the Delaware River Joint Toll Bridge Commission. Trenton is located near the exact geographic center of the state, which is 5 miles (8.0 km) located southeast of Trenton. The city is so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$50,019 to $61,310
Trenton, New Jersey area prices
were up 1.5% from a year ago

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