Operations Quality Auditor - Philadelphia, PA
Operations Quality Auditor - Philadelphia, PA
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
On behalf of VetJobs/MilitarySpouseJobs thank you for your interest. We are assisting our partnering company listed below with this position. It is open to Veterans Transitioning Military National Guard Members Military Spouses Wounded Warriors and their Caregivers. If you have the required skill set education requirements and experience please click the submit button and follow for next steps.
Under the direct supervision of the Supervisor Manager and/or Director of Operations Quality Auditing the Operations Quality Auditor is responsible for the timely and accurate review of various tasks performed by Operations (including but not limited to claims processing call handling and member/provider data maintenance).
Responsibilities:
Identifies system and/or operational issues hindering the attainment of quality performance standards as defined by AMFC policy and associated business rules
Provides issue identification problem analysis and strategies for resolution and/or implementation to Management
Accurately documents audit findings in the appropriate quality tool
Education and Experience:
High School/GED required
Minimum 3 years claims experience in a Medicaid environment
Claims processing knowledge required preferably with the Facets system
Working knowledge of Microsoft Office applications
Experience in call center operations and member/provider database maintenance preferred
Your career starts now. Were looking for the next generation of health care leaders.
At AmeriHealth Caritas were passionate about helping people get care stay well and build healthy communities. As one of the nations leaders in health care solutions we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products services and award-winning programs. AmeriHealth Caritas is seeking talented passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference wed like to hear from you.
Headquartered in Newtown Square PA AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive outcomes-driven care to those who need it most. We offer integrated managed care products pharmaceutical benefit management and specialty pharmacy services behavioral health services and other administrative services.
Discover more about us at .
Our Comprehensive Benefits Package
Flexible work solutions including remote options hybrid work schedules Competitive pay Paid time off including holidays and volunteer events Health insurance coverage for you and your dependents on Day 1 401(k) Tuition reimbursement and more.
Employment Type
Full Time
