Claims Quality Auditor

ManhattanLife Insurance & Annuity Company•Louisville, KY

5d•Onsite

About The Position

The Claims Quality Auditor is responsible for providing Quality Assurance of processed claims. Operational processes must be reviewed for accuracy to ensure adherence and quality output for our customers and internal partners. This role is based at our Louisville, Kentucky office.

Requirements

High School Graduate or equivalent (GED)
Experience, education, and/or training in QA and claims processes
Insurance knowledge and experience is a plus.
Solid knowledge of ICD-9, ICD-10 or medical coding.
Ability to read and understand policy language.
Understanding of basic medical terminology.
Ability to work independently and in a team environment.
Ability to prioritize and manage workload to meet deadlines.

Nice To Haves

1-3 years of claims experience preferred.
Background in insurance claims is preferred in any discipline of Medicare Supplement, Life, Health, Cancer or Disability.

Responsibilities

Audit internal paperwork and documentation as it transitions between Departments.
Ensure Claims are processed in adherence to company policy and contract provisions.
Ensure proper documentation accompanies all claims processed.
Audit output of group/customer-facing documents.
Manage all Audits, report discrepancies to case builder or leader; regression test corrections when provided.
Assist Management in assessing and documenting process improvement areas based on quality review.
Provide other Quality Assurance duties as needed by department.