Quality Assurance Auditor

IMS MARKETING INC • Amarillo, TX

23h • $16 - $17 • Onsite

About The Position

The Quality Assurance Auditor (described in the posting as Claims Auditor) investigates registered and processed claims and makes payment and procedural determinations. The role conducts root cause analysis and detailed reviews of group health plan documents, claims registration, and claims payment procedures. It reviews procedures, data entry, paid claims, and plan documents to provide quality assurance documentation. The position is based at the Amarillo, Texas office and is not remote.

Requirements

• Knowledge of medical terminology, anatomy, and physiology.
• Protect data integrity and validity.
• Follow HIPAA confidentiality regulations and guidelines for accessing and disclosing protected health information.
• Knowledge of correct coding principles for CPT, ICD-10, and HCPCS.
• Ability to communicate effectively.
• Ability to work independently with minimal supervision.
• Proficiency with Microsoft Office Suite, especially Outlook and Excel.
• Able and willing to commute to the Amarillo, Texas office.

Responsibilities

• Investigate registered and processed claims.
• Review claims and make payment and procedural determinations.
• Conduct root cause analysis and detailed reviews of group health plan documents and claims registration and payment procedures.
• Review procedures, data entry, paid claims, and plan documents to provide quality assurance documentation.
• Stay up to date on internal procedures.
• Perform other appropriate position duties in a competent, professional, and courteous manner.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed