Quality Auditor

Job Summary

A company is looking for a Quality Auditor to identify, analyze, and improve quality metrics in accordance with client contracts.

Key Responsibilities:

• Conduct audits and create quality reports to ensure compliance with SLA quality metrics
• Provide training and development support to employees and serve as a resource for management
• Interface with operations management to address quality and training issues professionally

Required Qualifications:

• High school diploma or equivalent required
• 2 to 3 years of relevant domain/industry experience, preferably in claims auditing
• Knowledge of end-to-end claims adjudication processes
• Familiarity with Molina SOPs is required
• Preferred knowledge of AZ and/or WA BH Medicaid regulations