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)
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JOB SUMMARY:
This position is responsible for providing the direction, organization, alignment, monitoring and cGMP compliance to ensure the successful, cost effective, timely and safe processing of customer orders. The position audits production room documentation, checks equipment challenges and hourly in-process inspections have been performed, ensures samples have been taken, and reviews room for 5S Compliance. These associates are responsible for performing real time batch record and documentation review during batch processing in order to drive improvements into our Right First Time (RFT) metrics. They are also responsible for leading and realizing continuous quality and process improvements on the production floor by mentoring, coaching and training their operational counterparts.
ESSENTIAL DUTIES AND RESPONSIBILITIES :
EDUCATION OR EQUIVALENT:
KNOWLEDGE/SKILLSREQUIREMENTS:
COMPUTER SKILLS:
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Must be physically capable to perform the above duties with or without reasonable accommodations which may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit. The employee is occasionally required to stand; walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
EQUAL OPPORTUNITY EMPLOYER/VET/DISABLED
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0 Claims Quality Auditor jobs found in Philadelphia, PA area