Lead Claims Quality Auditor

Job Summary

A company is looking for a Lead Claims Quality Auditor.

Key Responsibilities

• Conducts peer reviews of Claims Audit staff and provides training and mentorship
• Analyzes errors, performs root cause analysis, and recommends process improvements
• Develops and maintains departmental policies, procedures, and training materials

Required Qualifications

• Bachelor's Degree in a related field preferred
• 5+ years of experience in a healthcare organization required
• 3+ years of experience in understanding claims life cycle and interpreting contracts
• 2+ years of experience in a Senior Claims Auditor role preferred
• Preferred Certified Medical Coder certification