Performance Quality Auditor I

Elevance Health; Costa Mesa (CA); Remote; USD 100,000 - 125,000; Full time

Job summary

A leading healthcare company is looking for a Performance Quality Auditor I. The role requires evaluating the quality of services and interactions within the enterprise. Candidates should have a high school diploma and at least 2 years of relevant experience, preferably in healthcare or insurance. This position offers maximum flexibility as it allows virtual work with some required in-person training sessions.

Benefits

Comprehensive benefits package

Equity stock purchase

401k contribution

Qualifications

• Minimum 2 years experience in healthcare or insurance sector.
• Experience in enrollment and billing, claims, or customer contact environment.
• Strong preference for Carelon Behavioral Health experience.

Responsibilities

• Evaluate quality and accuracy of transactions and communications.
• Document and report transaction errors or communication issues timely.
• Track audit results and provide feedback to management.

Skills

Attention to detail

Quality evaluation

Analytical skills

Education

High school diploma or equivalent (GED)

Tools

FlexCare

Connects (CAS)

Job description

Position Title: Performance Quality Auditor I

Location: Virtual

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.

The Performance Quality Auditor I is responsible for evaluating the quality of services and interactions provided by organizations within the enterprise.

How you will make an impact:

• 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.
• Conducts routine audits, generally related to a single function on a single systems platform for a single line of business.

Minimum Requirements:

• Requires high school diploma or equivalent (GED); minimum 2 years experience with the company in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector); or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Carelon Behavioral Health experience strongly preferred
• Working knowledge of insurance industry and medical terminology and relevant systems and proven understanding of processing principles, techniques and guidelines strongly preferred.
• Ability to acquire and perform progressively more complex skills and tasks in a production environment strongly preferred.
• Knowledge and experience with FlexCare and/or Connects (CAS) processing systems strongly preferred.

The salary range for this specific position is $21.12/hr to $36.20/hr.

Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.