Quality Assurance Auditor

Job Summary

A company is looking for a QA Auditor, Appeals and Grievances.

Key Responsibilities

• Conduct quality audits of appeals and grievances, analyzing errors and determining root causes
• Record and track quality assessment scores, providing feedback to improve processes and performance
• Review and investigate appeals and grievances to ensure compliance and full resolution

Required Qualifications

• Experience with the investigation, resolution, and reporting of appeal and grievance processes
• Proficiency in Microsoft Office applications, particularly Excel, Word, and PowerPoint
• High School Diploma or GED from an accredited institution
• Experience in an auditing capacity conducting root cause analysis
• Knowledge of state and federal appeal and grievance regulatory requirements