Claims Quality Assurance Auditor

Job Summary

A company is looking for a Claims Quality Assurance Auditor.

Key Responsibilities

• Conduct regular audits and assessments of claims handling processes for compliance with standards and guidelines
• Document audit findings and prepare comprehensive reports with recommendations for improvement
• Collaborate with various teams to develop and implement quality control policies and training programs

Required Qualifications

• High School diploma or GED required; Bachelor's degree in Business Administration, Risk Management, or related field preferred
• 5+ years of workers' compensation claims experience with a strong understanding of claim handling practices
• 2+ years of experience in claims auditing, quality assurance, or compliance roles preferred
• Strong knowledge of Claims Best Practices and regulatory requirements across multiple jurisdictions
• Experience conducting claim file reviews and documenting audit findings