POSITION SUMMARY
Working independently and in groups the Quality Assurance Auditor will be responsible for the completion of multiple audit tasks including but not limited to auditing the builds of plan coders as needed for all new and existing revisions, along with compiling and reporting results and trends accurately. The QA Auditor is also responsible for auditing outgoing correspondence from the Medical Review, Appeals, and Refund teams, as well as complete audit of claim adjustments by the Rapid Response team. The QA Auditor will interpret the benefits in the plan documents to determine how benefits are payable and tracked/reported in the QicLink system.
ESSENTIAL FUNCTIONS
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
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