Claims Quality Assurance Auditor
Santa Clara Family Health Plan•San Jose, CA
426d•$72,385 - $108,578•Remote
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About The Position
The Claims Quality Assurance Auditor plays a crucial role in ensuring the accuracy, consistency, and quality of claims processing at Santa Clara Family Health Plan. This position involves conducting audits of claims processed against established guidelines and protocols, both manually and through auto-adjudication. The auditor is responsible for maintaining a comprehensive understanding of Medi-Cal and Medicare claims processing rules to ensure compliance with state and federal regulations, as well as internal policies.
