Job Description
**This position is 100% Remote.**
**Scope of Responsibilities:**
+ Conduct moderately complex to complex quality audits of provider claims, pre-payments and post-payments including high-dollar and specialized claims across multiple lines of business, claim types and products.
+ Audit the work of more junior auditors and identify opportunities for coaching and/or training.
+ Identify and communicate issues identified through audits and recommended solutions relevant to business operations.
+ Assist management in preparing departmental reports policies and procedures.
+ Mentor and coach Financial and/or Operations QA auditors.
+ Participate as a Subject Matter Expert on various process improvement projects designed to meet departmental and operational needs.
+ Assist with performing User Acceptance Testing (UAT) on system enhancements or corporate projects in partnership with Business Operations
+ Analyze errors and determine root causes for appropr...
**Scope of Responsibilities:**
+ Conduct moderately complex to complex quality audits of provider claims, pre-payments and post-payments including high-dollar and specialized claims across multiple lines of business, claim types and products.
+ Audit the work of more junior auditors and identify opportunities for coaching and/or training.
+ Identify and communicate issues identified through audits and recommended solutions relevant to business operations.
+ Assist management in preparing departmental reports policies and procedures.
+ Mentor and coach Financial and/or Operations QA auditors.
+ Participate as a Subject Matter Expert on various process improvement projects designed to meet departmental and operational needs.
+ Assist with performing User Acceptance Testing (UAT) on system enhancements or corporate projects in partnership with Business Operations
+ Analyze errors and determine root causes for appropr...