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performance quality Auditor

Description

Role: Performance Quality Auditor I

Location: Cincinnati, OH              

Duration: 3+ months


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 with information requested.


  • Produces other ad hoc reports as requested by internal and/or external clients.


  • Associates at this level conduct routine audits, generally related to a single function on a single systems platform for a single line of business. Requires high school diploma or equivalent (GED);


  • 2 years’ experience with the company in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector);

  • working knowledge of insurance industry and medical terminology

  • working knowledge of relevant systems and proven understanding of processing principles, techniques and guidelines;

  • ability to acquire and perform progressively more complex skills and tasks in a production environment or any combination of education and experience, which would provide an equivalent background.

Requirements

  • 2 years’ experience with the company in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector);

  • working knowledge of insurance industry and medical terminology

Job Snapshot

Location US-OH-Cincinnati
Employment Type Contractor
Pay Type Year
Pay Rate N/A
Store Type QA - Quality Control
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Company Overview

BCforward

BCforward is a global IT consulting and workforce fulfillment firm that provides services and resourcing for leading businesses and government organizations. For 20 years our professionals have helped clients achieve their strategic goals. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work. Learn More

Contact Information

US-OH-Cincinnati
Ramesh Mallempalli
317-210-8719
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Snapshot
BCforward
Company:
US-OH-Cincinnati
Location:
Contractor
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
QA - Quality Control
Store Type:

Description

Role: Performance Quality Auditor I

Location: Cincinnati, OH              

Duration: 3+ months


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 with information requested.


  • Produces other ad hoc reports as requested by internal and/or external clients.


  • Associates at this level conduct routine audits, generally related to a single function on a single systems platform for a single line of business. Requires high school diploma or equivalent (GED);


  • 2 years’ experience with the company in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector);

  • working knowledge of insurance industry and medical terminology

  • working knowledge of relevant systems and proven understanding of processing principles, techniques and guidelines;

  • ability to acquire and perform progressively more complex skills and tasks in a production environment or any combination of education and experience, which would provide an equivalent background.

Requirements

  • 2 years’ experience with the company in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector);

  • working knowledge of insurance industry and medical terminology

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