The Claims Quality Auditor - Senior selects claims through random processes and/or other criteria. Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Being a Claims Quality Auditor - Senior typically requires an associate's degree. Makes recommendations to improve quality, workflow processes, policies and procedures. In addition, Claims Quality Auditor - Senior typically reports to a supervisor or a manager. Claims Quality Auditor - Senior is a specialist on complex technical and business matters. Work is highly independent .... May provide a leadership role for the work group through knowledge in the area of specialization. Working as a Claims Quality Auditor - Senior typically requires 7+ years of related experience.More Show Less
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