Responsibilities

The Claims Auditor Lead will oversee the daily operation of the Claims Quality Team, including handling all aspects of the Claims’ Quality Review program, implementing and adhering to processing standards, responding to quality issues, and ensuring reports are complete and distributed timely. This role involves providing reports to department leaders on inventory, production, turn-around lag, and quality results, reviewing audits of claims, verifying processing accuracy, managing audit inventory, compiling reporting of audits, identifying trends, and partnering with training teams to develop quality improvement programs. The individual will also be responsible for mentoring the team, implementing performance improvement plans, training auditors, and positively influencing department morale by setting goals and fostering teamwork.