Senior Claims Audit & QA Specialist

University Health; San Antonio (TX); On-site; USD 65,000 - 85,000; Full time

Job summary

University Health in San Antonio, TX is seeking a skilled claims auditor to develop and maintain a comprehensive auditing program across all lines of business, aiming to improve processing standards and the overall quality of service provided to customers.

The role requires knowledge of HCFA/UB92 processing for commercial and Medicaid, plus Amisys CFHP systems, and a minimum of five years in insurance or managed care, including claim processing experience.

Qualifications

• High school diploma or equivalent.
• Minimum five years in insurance, medical or managed care environment.
• Two years of claim processing experience required.
• Auditing experience and Amisys knowledge preferred.

Responsibilities

• Develop and maintain claims auditing program for all lines of business to improve claims processing standards and monitor service quality.
• Identify processor and phone representative training needs to improve performance.
• Monitor the quality of service delivered to our customers.

Skills

Claims auditing

Claims processing

CFHP knowledge

Amisys

Education

High school diploma or equivalent

Tools

Amisys

Job description

University Health in San Antonio, TX is seeking a skilled claims auditor to develop and maintain a comprehensive auditing program across all lines of business, aiming to improve processing standards and the overall quality of service provided to customers.

The role requires knowledge of HCFA/UB92 processing for commercial and Medicaid, plus Amisys CFHP systems, and a minimum of five years in insurance or managed care, including claim processing experience.