The Senior Quality Assurance Claim Auditor is responsible for the oversight of the Quality Control Assurance Claim Auditors. They will be, in conjunction with the Supervisor of QA/Training, responsible for workload distribution and individual Quality Assurance Claim Auditor production work management. This individual will be the subject matter expert for the Quality Assurance Claim Auditor. The Senior Quality Assurance Claim Auditor will also be responsible for auditing and reporting the quality of work performed by the Quality Assurance Claim Auditors. This position will be responsible for generating and distributing all Quality Assurance monthly, quarterly and annual reports. They will also be responsible, in conjunction with the Quality Control Supervisor, for the Quarterly National Strategic Alliance audits. Reviews monthly trending reports to determine root cause analysis for identified errors. Recommends process and policy improvements based on error trending reviews. The Senior Quality Assurance Claim Auditor will be the initial point of contact for questions directed to the Quality Assurance department and will work directly with the Claim teams preparing for Client Audits. The Senior Quality Assurance Claim Auditor will also be responsible for updating and maintaining the Quality Assurance Department policies and procedures. Performs other duties as assigned.
Minimum Education: Two-year college degree or directly related business experience
Minimum Experience: Previous Claims Processing experience required. Previous Audit experience preferred.
" Excellent interpersonal, communication and judgment skills; detail oriented, ability to maintain a high level of accuracy and work within time constraints in a fast paced environment with changing priorities required.
" Knowledge of Microsoft applications required
" Experience with FACETS and Business Applications preferred.
" New York State Independent Adjusters license or the ability to obtain a NYS Independent Adjusters license.
MVP Health Care - 20 months ago
MVP Health Plan covers about 650,000 most valuable people. Also known as MVP Health Care, the company provides health insurance and employee...