Claims Quality Auditor I

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Claims Quality Auditor I 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 I makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Additionally, Claims Quality Auditor I typically reports to a supervisor or a manager. The Claims Quality Auditor I gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Claims Quality Auditor I typically requires 2 to 4 years of related experience.