Quality Auditor

Job Summary

Working remotely from anywhere in the United States, the Operations Quality Auditor will conduct timely and accurate quality reviews of operational functions, including claims processing, while ensuring adherence to established quality performance standards.

Key responsibilities

• Identify system and operational issues impacting quality performance standards
• Analyze audit results to determine root causes of errors or trends affecting quality outcomes
• Document audit findings and contribute to quality improvement initiatives

Required qualifications

• High School Diploma or GED required
• 3 years of provider experience in a Medicaid managed care environment required
• Claims processing knowledge, preferably using the Facets system required
• Experience in call center operations preferred
• Working knowledge of Microsoft Office applications required