Job Details

A company is looking for a Quality Assurance Auditor for Appeals and Grievances.Key ResponsibilitiesConduct quality audits of appeals and grievances, analyzing errors and determining root causesRecord and track quality assessment scores, providing feedback to improve processes and performanceReview and investigate appeals and grievances to ensure compliance and full resolutionRequired QualificationsExperience with investigation, resolution, and reporting of appeal and grievance processesProficiency in Microsoft Office Suite, including Excel, Word, and PowerPointHigh School Diploma or GED from an accredited institutionAssociate degree from an accredited institution (preferred)ICD10 certification (preferred)