| Claims Quality Auditor II Job Description |
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| The following is a full job description for Claims Quality Auditor II. Here are the requirements and responsibilities for Claims Quality Auditor II along with statistics. If after reading this page you determine that Claims Quality Auditor II is not the position you are looking for, you may want to try one of these similar titles: Claims Quality Auditor III, Claims Quality Auditor I, Claims Supervisor II, Claims Examiner II, Claims Adjuster II - P&C, Claims Quality Audit Supervisor, Claims Clerk II, Claims Quality Audit Director, Claims Quality Audit Manager |
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| Requirements and Responsibilities For Claims Quality Auditor II |
| Audits processed claims to evaluate accuracy, compliance, and adherence to policies, procedures, and regulatory requirements. Reviews claim decisions, payments, coding, and documentation against established standards and criteria. Identifies errors, discrepancies, and trends and documents findings clearly and objectively. Documents accuracy rates and prepares audit reports summarizing results and recommendations. Ensures compliance with company guidelines, audit standards, and applicable regulations. Requires a bachelor's degree. Typically reports to a manager. Occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. Typically requires 2-4 years of related experience. |
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| Also referred to as: Claims Quality and Compliance Auditor II, Claims Quality Auditor - Intermediate |
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| Similar Jobs: Claims Quality Auditor III, Claims Quality Auditor I, Claims Supervisor II, Claims Examiner II, Claims Adjuster II - P&C, Claims Quality Audit Supervisor, Claims Clerk II, Claims Quality Audit Director, Claims Quality Audit Manager |
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| Level of Education: Claims Quality Auditor II Salaries with No Diploma, Claims Quality Auditor II Salaries with a High School Diploma or Technical Certificate, Claims Quality Auditor II Salaries with an Associate's Degree, Claims Quality Auditor II Salaries with a Bachelor's Degree, Claims Quality Auditor II Salaries with a Master's Degree or MBA, Claims Quality Auditor II Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance, Pharmaceuticals | |
