Allied Benefit Systems · 3 days ago

Quality Assurance Auditor

United States

Full-time

Remote

Mid, Senior Level

5+ years exp

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Responsibilities

Log and track data to be audited

Audit outgoing correspondence from the Medical Review, Appeals, and Refund teams

Conduct complete audit of claim adjustments by the Rapid Response team

Communicate and coordinate with other departments involved in the audit process

Audit new and existing plans built by plan coders for all new and existing revisions

Assist with current audit programs in place as well as identify ways to improve audit results

Track and report audit trends and communicate training requirements to Management based on audit results

Monitor and track audit progress to ensure all audit task are complete by the determined deadline

Audit data for accuracy as well as workflow compliance

Other duties as assigned

Qualification

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AuditingMedical claimsDental claimsVision claimsMicrosoft WordMicrosoft ExcelWrittenVerbal communication skillsEffectively manage assigned workloadTPAHealth InsurancePlan coding familiarity