Quality Auditor

Job Summary

A company is looking for a Quality Auditor.

Key Responsibilities

• Perform audits of transactions processed by health plan administration associates
• Share QA results with associates and provide feedback on errors and improvement opportunities
• Maintain knowledge of CMS claims processing rules and guidelines for relevant health plans

Required Qualifications

• High School Diploma or GED required
• 3 years of health plan claims auditing operations experience required
• Medicare claims auditing experience preferred
• Proficiency in MS Suite, specifically Excel, PowerPoint, and Outlook
• Experience with HealthRules Payor or Guiding Care preferred