Performance Quality Auditor

Position Title:

Shift:

Job Description:

Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. 

Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.

Primary duties may include but are not limited to:

• Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.
• Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.
• Tracks and trends audit results, providing feedback to management. Identifies and reports on systemic issues which create ongoing quality concerns.
• Generates monthly reports of audit findings, supports clients with issues identified and develops reports to assist management ...