Claims Quality Auditor jobs in Syracuse, NY

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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Call Center Trainer and Quality Auditor
  • Research & Marketing Strategies, Inc.
  • Baldwinsville, NY FULL_TIME
  • REPORTS TO: QualiSight Call Center Supervisor
    RMS is hiring a full-time Call Center Trainer and Quality Auditor (QA) to join our collaborative team of go-getters
    in the RMS QualiSight Call Center. RMS is passionate about survey research and is currently seeking a highly
    motivated and talented individual to train, coach, and mentor our fantastic group of telephone interviewers!
    The right candidate will be experienced and well-versed in call center training techniques and will join our team
    eager to dive in and learn all about conducting market research! The Trainer and QA will train staff and conduct
    ongoing training through call audits and live listening to provide regular and timely feedback to the call center
    team for a wide variety of industry projects including healthcare, education, manufacturing, the food industry,
    and more. You will have the opportunity to work on various types of projects as well, so there’s always
    something new to learn! If you are friendly and motivated and love to train people, this is the full-time
    opportunity for you!
    The Training and QA position allows for a flexible schedule, with availability for shifts during mornings,
    afternoons, evenings, and Saturdays to ensure touchpoints will all the call center staff. We work with your
    schedule to help provide a stable work-life balance. After your 60-day introductory period, you will also be
    eligible for full company benefits including health, dental, vision, life, vacation, and retirement.

    SPECIFIC DUTIES AND RESPONSIBILITIES

    1. Reporting directly to the QualiSight Call Center Supervisor, the Trainer and QA will complete call audits
    on every staff member for all projects including all CAHPS® product lines, adhering to project guidelines
    and ensuring that minimum audit requirements are met.

    2. Conduct new hire training with new TSAs utilizing established new hire training materials. The Trainer
    and QA will also maintain the TSA Cross Training Log for the department.

    3. Review annual CAHPS® training updates to stay current with project requirements and any new
    guidelines. The Trainer and QA will identify and incorporate any new updates into the department’s
    annual training sessions for the TSAs.

    4. Attend regular department team meetings to discuss existing and new project work, quality goals, and
    training needs. The Trainer and QA will identify the required quality output parameters for all projects to
    better provide “Best in Class” results through the call auditing and data check process.

    5. Through conducting call audits and quality checks, the Trainer and QA will identify and report specific
    problems to the Call Center Supervisor offering possible solutions through programming, scripting, or
    training. The QA will address any immediate concerns to the TSAs and work to incorporate findings into
    team calibration sessions to share best practices with other team members.

    6. The Trainer and QA will work with the supervisor to coordinate impromptu and regular team calibration
    sessions designed to share best practices with the team. A regular schedule of team calibration and
    training sessions should be maintained with a variety of rotating topics to keep staff performance to a
    high standard. The Trainer and QA will maintain a log of all group training activities and attendees and
    will log all coaching activities.

    7. Populate monthly audit reports for every project and product type to include detailed call evaluation
    data for every TSA.

    8. Performs TSA operations to test, and provide feedback about script flow, as well as to augment existing
    staff as deemed necessary by the department head.

    MINIMUM POSITION REQUIREMENTS

    • Demonstrated call center experience with a focus on quality improvement and training.
    • Effective oral and written communication skills, and strong attention to detail.
    • Working knowledge of Microsoft Office (Word, Excel, Outlook, and Access) and CATI style survey

    software desired.

    • Ability to work independently and follow through on own initiative is essential.
    • Ability to manage multiple priorities, with frequent tight time constraints required.
    • Excellent interpersonal and customer service focused skills and ability to work with diverse groups of

    people required.

    **This position may require access to patient Protected Health Information (PHI) and may also involve access to electronic
    Protected Health Information (ePHI). Those in this position are required to comply with all final regulations including the Health
    Insurance portability and Accountability Act of 1996 (HIPAA). Intentional or inadvertent disclosure of PHI or ePHI violates
    federal law and can result in termination and/or fines. Additionally, employees in this position are required to notify the Privacy
    Officer of any suspected incidents whereby RMS is not in full compliance with HIPAA. RMS will provide HIPAA training
    opportunities for the employee to remain current of HIPAA requirements.

    To apply, please submit a resume, salary history and cover letter to the following:
    Karina Tennant
    15 East Genesee Street, Suite 210
    Info@
    Apply Here
    Position Description- Telephone Survey Associate 07-2023

    Job Type: Full-time

  • 23 Days Ago

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Field Technician
  • Hancock Claims Consultants
  • Watertown, NY CONTRACTOR
  • CLIMB to New Heights… And live the_ American Dream. _Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carri...
  • 22 Days Ago

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Claims Specialist
  • CorVel Corporation
  • Syracuse, NY FULL_TIME
  • The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under...
  • Just Posted

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Claims Analyst
  • Laland Baptiste
  • Syracuse, NY FULL_TIME
  • Claims Analyst, Syracuse, NY (231C)Laland Baptiste, LLC is a certified minority and woman owned construction management and consulting firm. Laland Baptiste provides innovative and professional servic...
  • 3 Days Ago

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Claims Advocate
  • Haylor Freyer & Coon, Inc.
  • Syracuse, NY FULL_TIME
  • Claims Advocate Claims Syracuse, NY Haylor.com At Haylor, Freyer & Coon, we believe that talented, caring people make all the difference. HF&C is a Top 100 Independently Owned Insurance Agency, recogn...
  • 27 Days Ago

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Regional owner operator
  • Quality Carriers
  • Syracuse, NY FULL_TIME
  • Class-A CDL Regional Owner Operator SYRACUSE, NY Responsibilities Requirements : CDL-A with Tanker and Hazmat Endorsements (Terminal Will Reimburse for Hazmat) Must Be Willing to Obtain a TWIC Card - ...
  • 1 Day Ago

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0 Claims Quality Auditor jobs found in Syracuse, NY area

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Auditor 1 (Municipal) (NY HELPS), SG-18 Auditor Trainee 2 (Municipal) (NY HELPS), SG-16 Auditor Trainee 1 (Municipal) (NY HELPS), SG-14, Item#150699
  • StateJobsNY
  • Syracuse, NY
  • Do you want a career with a purpose that provides work/life balance? Apply today to join the Office of the New York Stat...
  • 4/26/2024 12:00:00 AM

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Auditor 1 (Municipal) (NY HELPS), SG-18 Auditor Trainee 2 (Municipal) (NY HELPS), SG-16 Auditor Trainee 1 (Municipal) (NY HELPS), SG-14, #150699
  • New York State Civil Service
  • Syracuse, NY
  • Agency State Comptroller, Office of the Title Auditor 1 (Municipal) (NY HELPS), SG-18 Auditor Trainee 2 (Municipal) (NY ...
  • 4/26/2024 12:00:00 AM

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Supervisor Materials Management & Sterile Reprocessing
  • Crouse Hospital
  • Syracuse, NY
  • As the evening Supervisor of Materials Management, your skills and expertise will be necessary to lead a team of hardwor...
  • 4/25/2024 12:00:00 AM

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Commercial Insurance Account Manager - Fully Remote for NORTHEAST
  • Insurance Office of America
  • Syracuse, NY
  • Description Position at Insurance Office of America ***This is a fully remote role supporting our Producer Operations De...
  • 4/25/2024 12:00:00 AM

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Technical Writer
  • Trinity Consultants - Advent Engineering Life Science Solutions
  • Syracuse, NY
  • On-Site Technical Writer - Upstate New York ADVENT's services include process engineering, automation engineering, proje...
  • 4/24/2024 12:00:00 AM

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GEIS North America Senior Finance Manager
  • Eaton
  • Syracuse, NY
  • Eaton Global Energy Infrastructure Solutions (GEIS) organization is seeking a North America (NA) Controller. This positi...
  • 4/24/2024 12:00:00 AM

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Program Administrator
  • National Safety Council
  • Syracuse, NY
  • Save lives, from the workplace to anyplace. The National Safety Council is America’s leading safety advocate. We enable ...
  • 4/22/2024 12:00:00 AM

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Technical Writer
  • Trinity Consultants - Advent Engineering Life Science Solutions
  • Syracuse, NY
  • On-Site Technical Writer - Upstate New York ADVENT's services include process engineering, automation engineering, proje...
  • 4/22/2024 12:00:00 AM

Syracuse is located at 43°2′49″N 76°8′40″W / 43.04694°N 76.14444°W / 43.04694; -76.14444 (43.046899, -76.144423). It is located about 87 miles (140 km) east of Rochester, 131 miles (210 km) east of Buffalo,and 150 miles (240 km) west of the state capital Albany. It is also the halfway point between New York City and Toronto, about 245 miles (390 km) from each, Toronto to the northwest and NYC to the southeast. According to the United States Census Bureau, the city has a total area of 25.6 square miles (66 square kilometres), of which 25.1 square miles (65 square kilometres) is land and 0.6...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$45,703 to $56,018
Syracuse, New York area prices
were up 1.5% from a year ago

Claims Quality Auditor in Bloomington, IN
Evaluates claims activities of other departments and / or companies.
December 05, 2019