How to Become a Claims Quality Auditor

Step 1: Understand the job description and responsibilities of a Claims Quality Auditor

What does a Claims Quality Auditor do?

A Claims Quality Auditor audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Being a Claims Quality Auditor makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Additionally, Claims Quality Auditor typically reports to a supervisor or a manager. The Claims Quality Auditor contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Claims Quality Auditor typically requires 4 to 7 years of related experience.

People's Opinions on Claims Quality Auditor responsibilities

Provides Claims performance / quality / audit reviews.

02/20/2020: Ann Arbor, MI

Interacts with various levels of Claims management to communicate audit findings and recommend solutions for continuous process improvement.

02/04/2020: New Bedford, MA

Evaluates claims activities of other departments and / or companies.

12/05/2019: Bloomington, IN
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Step 2: Learn best tips to become a Claims Quality Auditor

Best tips for those who want to become a Claims Quality Auditor

Here are some tips to become a Claims Quality Auditor.

People's Opinions on best tips

Exceeds Job Related Expectations.

12/30/2019: Fort Myers, FL
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Step 3: View best colleges and universities for Claims Quality Auditor

Best colleges and universities for Claims Quality Auditor

  • Butler University
  • Carroll College
  • Cooper Union
  • High Point University
  • Princeton University
  • Providence College

Step 4: Think about whether is it worth to be a Claims Quality Auditor

Is being a Claims Quality Auditor Worth it?

People's Opinions on lifestyles

3-5 years of professional claims experience or similar activity outside of the organization.

02/05/2020: Columbus, OH

Experience in auditing, claims management, and litigation management is required.

12/10/2019: Greenville, SC

Our leadership is dedicated to putting patients first—a cornerstone of our mission, vision and values—as we deliver top-quality healthcare.

02/04/2020: Lebanon, PA

Oversees, audit findings and provide education to claims staff and other internal customers within PIH.

12/21/2019: Rochester, MN

2+ years of experience utilizing claims platforms such as UNET, CSP Facets, COSMOS, FACETS.

02/19/2020: San Antonio, TX
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Step 5: Prepare relevant skills for being a Claims Quality Auditor

What skills do you need to be a Claims Quality Auditor?

This is not a management position, but still requires important skills in order to fully execute the role.  A keen understanding of the following is necessary for the role: Claim Investigation, Quality Assurance Process, AD-hoc Audits, Claim Auditing Management, Claim Process Improvement, Claim Reviews, Claim Settlement Policies.  Some of the more basic skills utilized in this role include: Insurance Claims Management Software.  These skills are certainly important to the role, but keep in mind, fit into a company culture and environment is often just as important.

People's Opinions on Claims Quality Auditor skills

10+ years insurance claims experience, including claims adjusting, claims auditing and/or claims supervision.

02/01/2020: Fort Worth, TX

BS/BA degree preferred and a minimum of five years of recent experience as a medical/dental/vision claims auditor and five years’ experience processing group….

02/06/2020: Battle Creek, MI

Experience in claims handling of Bodily Injury claims required.

12/22/2019: Rochester, NY

3-5 years of professional claims experience or similar activity outside of the organization.

02/09/2020: Alamogordo, NM

+ 3 years experience with claims processing and data management + Past auditing and strong….

01/19/2020: Houston, TX
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Step 6: View average salary for Claims Quality Auditor

How much does a Claims Quality Auditor make?

The average salary range for a Claims Quality Auditor is from $47,288 to $59,058. The salary will change depending on your location, job level, experience, education, and skills.

Salary range for a Claims Quality Auditor
$47,288 to $59,058

Step 7: Find relevant Claims Quality Auditor jobs, and apply.

Looking for Claims Quality Auditor jobs?

Here are some Claims Quality Auditor jobs in the United States.

Search Claims Quality Auditor Jobs in the United States

Step 8: Explore Career Path of Claims Quality Auditor

Step 8: Explore Career Path of Claims Quality Auditor? Claims Quality Auditor II