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 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 typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Your Role
The Medi-Cal Claims Operations team is responsible for ensuring claims are processed accurately and timely. The Quality Assurance Auditor, Advanced will report to the Medi-Cal Operations Manager. In this role you will be responsible for performing audits that are routine in nature for the Medi-Cal line of business for all claim types.
Your Work
In this role, you will:
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0 Claims Quality Auditor jobs found in Long Beach, CA area