Claims Quality Assurance Director
Job Summary
Responsible for overseeing a comprehensive claims quality assurance program, the full-time salaried Claims Quality Assurance Director will conduct audits, ensure regulatory compliance, and develop training programs, all while working remotely from Arizona.
Key responsibilities
- Conduct monthly claim file audits and establish QA metrics and performance benchmarks
- Ensure compliance with state regulations and carrier-specific claims handling guidelines
- Design and implement training programs for claims quality improvement
Required qualifications
- Proven experience in claims quality assurance or a related field
- Strong understanding of insurance regulations and compliance standards
- Experience in performance analytics and KPI reporting
- Ability to develop and deliver training programs
- Familiarity with vendor and TPA oversight processes
Complete Job Description
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