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QA Auditor, Medical Claims

Company: MultiPlan
Location: Alpharetta
Posted on: January 10, 2022

Job Description:

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and-- -inspire-- -positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by-- -interpreting-- -our client's needs and tailoring-- -innovative-- -healthcare cost management solutions. Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talent individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine! You will have a steady Monday through Friday 40 hour per week schedule between the hours of 7:00 am and 5:00 pm.-- - Employees are able to pick from available flexible schedules after completing training. This position can be remote or, a work from home position but will be located in our Arlington, TX.-- - Earn $15.40 per hour ( Pay varies depending on employees state of residence) and have the opportunity to receive additional quarterly bonuses based on performance after completion of the probationary period. We provide equipment needed and an excellent paid virtual classroom training program as well as continuous on the job coaching and mentoring.-- --- -We also have advancement and growth opportunities available to employees. Find more information on what it's like to be a MultiPlan employee on our Careers page at-- - JOB SUMMARY: To perform daily audits of work performed in assigned operational areas to ensure work adheres to processes as defined by each specific area and meets or excees the set quality standard. To deliver audit results in a timely and consistent manner, meeting all department quality and production goals ane remaining current with all applicable business and audit processes. JOB ROLES AND RESPONSIBILITIES:1. Perform daily audits and follow standard processes and procedures for assigned positions.2. Identify recurring issues for review and recommendations.3. Display basic understanding of standard review processes and work flows, providing consistency and appropriate detail in alignment with all policies and procedures, business rules and overall department guidelines.4. Maintain consistent quality and production standards with consideration around specific audit and turnaround time expectations.5. Collaborate, coordinate, and communicate across disciplines and departments.6. Ensure compliance with HIPAA regulations and requirements.7. Demonstrate Company's Core Competencies and values held within.8. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.Please note due to the exposure of PHI sensitive data - this role is considered to be a High Risk Role.JOB SCOPE:This job works under general supervision to complete job responsibilities. The incumbent possesses and applies a range of knowledge gained through experience to complete the job responsibilities. One uses established guidelines and experience to resolve issues and refers more complex issues to higher levels.

Keywords: MultiPlan, Alpharetta , QA Auditor, Medical Claims, Healthcare , Alpharetta, Georgia

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