Job Summary
A health insurance company is searching for a person to fill their position for a Telecommute Appeals and Grievances QA Auditor.
Core Responsibilities of this position include:
- Perform internal QA audits of operational processes for internal employees and outsourced vendors
- Ensure compliance with policies, procedures and quality standards
- Handle processing of audit determinations and track and trend findings
Qualifications for this position include:
- High School Diploma or GED from an accredited institution
- Experience with the investigation, resolution, and reporting of appeal and grievance processes
- Able to conduct quality audits of A&G items
- Experience in Excel to format formulas, manage data, and filtering results
- Experience in Word and PowerPoint
