Senior Quality Auditor
Company: VirtualVocations
Location: Sioux Falls
Posted on: March 12, 2025
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Job Description:
A company is looking for a Senior Quality Auditor to develop and
implement effective business solutions through research, audit, and
analysis of data and business processes.
Key Responsibilities
Audit and validate routine pre and post payment claims for
compliance with policies and regulatory guidelines
Perform routine and moderately complex audits on medical review
claims to identify exceptions
Research claims issues to determine origins and appropriate
resolutions, summarizing findings in reports for management
Required Qualifications
High School Diploma or equivalent; some college coursework
preferred
Four years of general data management experience in claims
processing or provider maintenance
Knowledge of health insurance industry regulations and
certification standards
Experience with auditing provider data and claims processing
systems
Ability to maintain current knowledge of relevant products,
policies, and procedures
Keywords: VirtualVocations, Sioux Falls , Senior Quality Auditor, Accounting, Auditing , Sioux Falls, South Dakota
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