Claims Quality Auditor & Process Improver

Versant Health; City of Troy (NY); On-site; USD 28,000 - 40,000; Full time

Benefits offered by this job

Medical benefits

Dental and vision coverage

Paid time off

Job summary

Versant Health is seeking a Claims Audit Specialist to lead quality reviews of operations, analyze findings, and drive process improvements across departments. The role emphasizes accuracy, compliance, and collaborative problem solving within a fast-paced environment.

Ideal candidates will have a Bachelor's degree and 3+ years in claims, quality assurance, or process improvement, plus proficiency in Microsoft Office and bilingual abilities.

Qualifications

• Bachelor's degree in a related field or equivalent combination of education and experience.
• One year of related experience in Quality Review, Quality Assurance, or Process Improvement preferred.
• Three years of related experience in Claims required.
• Bilingual skills a plus; strong proficiency in Microsoft Office.

Responsibilities

• Conduct quality reviews of functions within Operations.
• Recommend corrections/changes to systems, policies, and procedures to improve quality.
• Provide feedback to associates and management to improve workflow and reduce errors.
• Assist the department Manager with routine quality program reviews to ensure compliance.
• Provide regular feedback and recommendations to the department Manager regarding staff performance.
• Maintain documentation for SSAE 16 and Financial audits as required.
• Assist in department/corporate projects to implement system or policy changes accurately.
• Other duties as assigned.

Skills

Quality Review

Process Improvement

Claims Knowledge

Bilingual

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Versant Health is seeking a Claims Audit Specialist to lead quality reviews of operations, analyze findings, and drive process improvements across departments. The role emphasizes accuracy, compliance, and collaborative problem solving within a fast-paced environment.

Ideal candidates will have a Bachelor's degree and 3+ years in claims, quality assurance, or process improvement, plus proficiency in Microsoft Office and bilingual abilities.