QA Auditor, Medical Claims
Location: Kansas City
Posted on: January 15, 2022
JOB SUMMARY: To perform daily audits of work performed in
assigned operational areas to ensure work adheres to processes as
defined by each specific area and meets or excees the set quality
standard. To deliver audit results in a timely and consistent
manner, meeting all department quality and production goals ane
remaining current with all applicable business and audit processes.
JOB ROLES AND RESPONSIBILITIES:1. Perform daily audits and follow
standard processes and procedures for assigned positions.2.
Identify recurring issues for review and recommendations.3. Display
basic understanding of standard review processes and work flows,
providing consistency and appropriate detail in alignment with all
policies and procedures, business rules and overall department
guidelines.4. Maintain consistent quality and production standards
with consideration around specific audit and turnaround time
expectations.5. Collaborate, coordinate, and communicate across
disciplines and departments.6. Ensure compliance with HIPAA
regulations and requirements.7. Demonstrate Company's Core
Competencies and values held within.8. The position
responsibilities outlined above are in no way to be construed as
all encompassing. Other duties, responsibilities, and
qualifications may be required and/or assigned as necessary.Please
note due to the exposure of PHI sensitive data - this role is
considered to be a High Risk Role.JOB SCOPE:This job works under
general supervision to complete job responsibilities. The incumbent
possesses and applies a range of knowledge gained through
experience to complete the job responsibilities. One uses
established guidelines and experience to resolve issues and refers
more complex issues to higher levels.
Keywords: MultiPlan, Kansas City , QA Auditor, Medical Claims, Accounting, Auditing , Kansas City, Kansas
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