Claims Quality Auditor II

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Claims Quality Auditor II 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 II makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Additionally, Claims Quality Auditor II typically reports to a supervisor or a manager. The Claims Quality Auditor II contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Claims Quality Auditor II typically requires 4 to 7 years of related experience.