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)
Recent and Upcoming College Graduates are encouraged to apply, no experience needed. No sales or phone work required.
Delaware Claims Processing Facility has openings in its downtown Wilmington, DE location for Claims Analysts
Qualifications
Ideal candidates will be hard working with a high energy level; the ability to remain focused and recall data is key. This position requires excellent organizational skills, and strong reading comprehension skills. Along with the ability to work independently in a team environment, candidates should be able to grasp new concepts quickly. Comfort in an ever-changing production environment, and Associates or Bachelor’s Degree needed. Must be able to learn and apply new concepts.
Duties
Review Claims in accordance with Review procedures. Take a proactive approach to claims processing and utilize resources to ensure proper handling of all claims. Maintain satisfactory or better quality and productivity standards. Portray a positive claimant focused attitude. Maintain a professional demeanor at all times.
In addition to a pleasant and professional working environment, Delaware Claims Processing Facility offers a competitive salary and benefits package to include transportation allowance, tuition reimbursement, 401-K, hybrid work from home plans and more.
Apply online here or visit our website to learn more about DCPF and what we can offer you www.delcpf.com
Delaware Claims Processing Facility is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
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