Performance Quality Auditor

Position Title

Performance Quality Auditor

Job Description Summary

Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise, including processes related to enrollment, billing, claims processing, and customer service inquiries.

Responsibilities

• 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 with information requested.
• Produces other ad hoc reports as requested by...