Senior Performance Quality Auditor

elevancehealth; Indianapolis (IN); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Elevance Health is seeking a Performance Quality Audit III to evaluate the quality and accuracy of transactions and communications across enrollment, billing, claims processing, and customer service inquiries. This role operates within the CarelonRx unit and reports to the quality leadership.

The ideal candidate brings extensive audit experience in the insurance/healthcare domain, strong attention to detail, and the ability to work in a hybrid environment with in-office collaboration 1–2 days

Qualifications

• Requires high school diploma or GED; minimum 5 years experience or equivalent background.
• Bachelor's degree strongly preferred.

Responsibilities

• Evaluates the quality and accuracy of transactions and/or communications.
• Identifies, documents, and reports any transaction errors or communications issues in a timely manner.
• Tracks and trends audit results to provide feedback to management.
• Identifies and reports on systemic issues causing quality concerns.
• Generates monthly audit reports and supports clients with identified issues.
• Provides training, mentoring and support to quality staff.
• Conducts routine to complex audits across multiple functions and systems.

Skills

Audit

Insurance knowledge

Medical terminology

Quality control

Education

High school diploma or GED

Bachelor's degree (preferred)

Job description

Elevance Health is seeking a Performance Quality Audit III to evaluate the quality and accuracy of transactions and communications across enrollment, billing, claims processing, and customer service inquiries. This role operates within the CarelonRx unit and reports to the quality leadership.

The ideal candidate brings extensive audit experience in the insurance/healthcare domain, strong attention to detail, and the ability to work in a hybrid environment with in-office collaboration 1–2 days