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Performance Quality Auditor I ...

Monster
 
 
 
 

Job Summary

Company
Anthem
Location
South Portland, ME
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_PS4736

Performance Quality Auditor I - South Portland, ME - PS4736

About the Job

Description

Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Performance Quality Auditor I

Location: South Portland, ME

****THIS POSISTION REQUIERS YOU TO BE IN OFFICE. NOT A REMOTE OR WORK FROM HOME OPPORTUNITY.

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.

Qualifications

****THIS POSISTION REQUIERS YOU TO BE IN OFFICE. NOT A REMOTE OR WORK FROM HOME OPPORTUNITY.

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.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers.

EOE. M/F/Disability/Veteran.

 

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