Claims Quality Auditor III 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 III makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Additionally, Claims Quality Auditor III typically reports to a supervisor or a manager. Claims Quality Auditor III is a specialist on complex technical and business matters. Work is highly independent. May provide a leadershi...View More
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