| Claims Quality Auditor III Job Description |
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| The following is a full job description for Claims Quality Auditor III. Here are the requirements and responsibilities for Claims Quality Auditor III along with statistics. If after reading this page you determine that Claims Quality Auditor III is not the position you are looking for, you may want to try one of these similar titles: Claims Quality Auditor II, Claims Quality Auditor I, Claims Examiner III, Disability Claims Examiner III, Claims Adjuster III - P&C, Claims Quality Audit Supervisor, Claims Clerk III, Claims Quality Audit Director, Claims Quality Audit Manager |
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| Requirements and Responsibilities For Claims Quality Auditor III |
| 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. Work is generally independent and collaborative in nature. Contributes to moderately complex aspects of a project. Typically requires 4-7 years of related experience. |
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| Also referred to as: Claims Quality and Compliance Auditor III, Claims Quality Auditor - Senior |
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| Similar Jobs: Claims Quality Auditor II, Claims Quality Auditor I, Claims Examiner III, Disability Claims Examiner III, Claims Adjuster III - P&C, Claims Quality Audit Supervisor, Claims Clerk III, Claims Quality Audit Director, Claims Quality Audit Manager |
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| Level of Education: Claims Quality Auditor III Salaries with No Diploma, Claims Quality Auditor III Salaries with a High School Diploma or Technical Certificate, Claims Quality Auditor III Salaries with an Associate's Degree, Claims Quality Auditor III Salaries with a Bachelor's Degree, Claims Quality Auditor III Salaries with a Master's Degree or MBA, Claims Quality Auditor III Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare, Insurance, Pharmaceuticals | |
