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Alternate job titles: Claims Quality and Compliance Auditor I | Claims Quality Auditor - Associate

Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Typically reports to a supervisor or a manager. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. Typically requires 2 to 4 years of related experience. more...



Alternate job titles: Claims Quality and Compliance Auditor II | Claims Quality Auditor - Intermediate

Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Typically reports to a supervisor or a manager. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. Typically requires 4 to 7 years of related experience. more...


Alternate job titles: Claims Quality and Compliance Auditor III | Claims Quality Auditor - Senior

Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Typically reports to a supervisor or a manager. A specialist on complex technical and business matters. Work is highly independent. May provide a leadership role for the work group through knowledge in the area of specialization. Typically requires 7+ years of related experience. more...


Alternate job titles: Claims Quality Auditor II | Claims Quality and Compliance Auditor II

The Claims Quality Auditor - Intermediate selects claims through random processes and/or other criteria. Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Being a Claims Quality Auditor - Intermediate typically requires an associate's degree. Makes recommendations to improve quality, workflow processes, policies and procedures. In addition, Claims Quality Auditor - Intermediate typically reports to a supervisor or a manager. Being a Claims Quality Auditor - Intermediate contributes to moderately complex aspects of a projec more...



Alternate job titles: Claims Quality Auditor I | Claims Quality and Compliance Auditor I

The Claims Quality Auditor - Associate selects claims through random processes and/or other criteria. Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Being a Claims Quality Auditor - Associate typically requires an associate's degree. Makes recommendations to improve quality, workflow processes, policies and procedures. In addition, Claims Quality Auditor - Associate typically reports to a supervisor or a manager. Being a Claims Quality Auditor - Associate gains exposure to some of the complex tasks within the job functi more...


Alternate job titles: Claims Quality Auditor III | Claims Quality and Compliance Auditor III

The Claims Quality Auditor - Senior selects claims through random processes and/or other criteria. Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Being a Claims Quality Auditor - Senior typically requires an associate's degree. Makes recommendations to improve quality, workflow processes, policies and procedures. In addition, Claims Quality Auditor - Senior typically reports to a supervisor or a manager. Claims Quality Auditor - Senior is a specialist on complex technical and business matters. Work is highly independent more...



Alternate job titles: Claims Quality Auditor I | Claims Quality Auditor - Associate

The Claims Quality and Compliance Auditor I selects claims through random processes and/or other criteria. Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Being a Claims Quality and Compliance Auditor I typically requires an associate's degree. Makes recommendations to improve quality, workflow processes, policies and procedures. In addition, Claims Quality and Compliance Auditor I typically reports to a supervisor or a manager. Being a Claims Quality and Compliance Auditor I gains exposure to some of the complex tasks w more...


Alternate job titles: Claims Quality Auditor II | Claims Quality Auditor - Intermediate

The Claims Quality and Compliance Auditor II selects claims through random processes and/or other criteria. Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Being a Claims Quality and Compliance Auditor II typically requires an associate's degree. Makes recommendations to improve quality, workflow processes, policies and procedures. In addition, Claims Quality and Compliance Auditor II typically reports to a supervisor or a manager. Being a Claims Quality and Compliance Auditor II contributes to moderately complex aspects more...


Alternate job titles: Claims Quality Auditor III | Claims Quality Auditor - Senior

The Claims Quality and Compliance Auditor III selects claims through random processes and/or other criteria. Audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Being a Claims Quality and Compliance Auditor III typically requires an associate's degree. Makes recommendations to improve quality, workflow processes, policies and procedures. In addition, Claims Quality and Compliance Auditor III typically reports to a supervisor or a manager. Claims Quality and Compliance Auditor III is a specialist on complex technical and busi more...



Alternate job titles: Automotive Claims Adjuster II | Claims Investigator II | Insurance Claims Adjuster, Experienced | Property/Casualty Claims Adjuster II

There is currently no job description for Pharmacy Claims Auditor. Be the first to submit the job responsibilities for a Pharmacy Claims Auditor.


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