Senior Claims Auditor & Process Quality Lead

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

Job summary

A health plans organization in San Antonio is seeking a Claims Auditor to manage and enhance their claims auditing program. The role involves overseeing claims processing standards and ensuring high-quality service delivery to customers. Candidates should have at least five years of experience in the insurance or managed care sectors, with a focus on claims processing. A high school diploma is required, with preference for those having auditing experience and knowledge of the Amisys system.

Qualifications

• Minimum of five years experience in insurance or managed care environment.
• Two years of claim processing experience required.
• Previous auditing and/or Amisys experience preferred.

Responsibilities

• Develop and maintain claims auditing program.
• Improve claims processing standards.
• Monitor quality of service delivered to customers.

Education

High school diploma or equivalency

Experience in insurance, medical or managed care

Job description

A health plans organization in San Antonio is seeking a Claims Auditor to manage and enhance their claims auditing program. The role involves overseeing claims processing standards and ensuring high-quality service delivery to customers. Candidates should have at least five years of experience in the insurance or managed care sectors, with a focus on claims processing. A high school diploma is required, with preference for those having auditing experience and knowledge of the Amisys system.