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)
Calling all road warriors! This position is very travel heavy (at least 2 weeks of overnight travel a month) with the ability to work from home when not traveling.
The Quality Assurance Auditor conducts routine mock surveys to assess regulatory compliance with federal, state, and local regulations and to ensure centers provide quality nursing care and services. Additionally, the Quality Assurance Auditor partners with the center and regional leadership to create plans of correction based on the mock survey results and monitors the center’s progress towards completing the plan. Provides additional support to sustain survey readiness as needed.
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0 Claims Quality Auditor jobs found in Portland, OR area