Claims Quality Auditor I Jobs

Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Typically reports to a supervisor or a manager. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. Typically requires 2 to 4 years of related experience.