Claims Quality Auditor III 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. 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. Typically requires 7+ years of related experience.