Senior Global Quality Auditor
Eli Lilly and CompanySalary not specified
Not SpecifiedCompensation
Mid-level (3 to 4 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, InsuranceIndustries
Requirements
- BA/BS degree; 3 years of experience including a minimum of 1 year of related experience in a quality audit capacity (preferably in healthcare or insurance sector); or any combination of education and experience which would provide an equivalent background
- Working knowledge of insurance industry and medical terminology
- Detailed knowledge of relevant systems
- Proven understanding of processing principles, techniques, and guidelines
- Ability to acquire and perform progressively more complex skills and tasks in a production environment
Responsibilities
- Evaluating the quality of services and interactions provided by organizations within the enterprise, including processes related to enrollment and billing, claims processing, and customer service written and verbal inquiries
- Evaluating the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders
- Identifying, documenting, and reporting any transaction errors or communications issues in a timely manner to ensure prompt resolution
- Tracking and trending audit results, providing feedback to management, and identifying and reporting on systemic issues which create ongoing quality concerns
- Generating monthly reports of audit findings, supporting clients with issues identified, and developing reports to assist management with information requested
- Producing other ad hoc reports as requested by internal and external clients
- Conducting routine to complex audits, generally related to one or more functions on one or more systems platform for one or more lines of business
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
What education and experience are required for the Performance Quality Auditor role?
A BA/BS degree is required along with 3 years of experience, including at least 1 year in a quality audit capacity, preferably in healthcare or insurance. Equivalent combinations of education and experience are also accepted.
What key skills are needed for this position?
Candidates need working knowledge of the insurance industry and medical terminology, detailed knowledge of relevant systems, and a proven understanding of processing principles, techniques, and guidelines. The ability to acquire and perform progressively more complex skills in a production environment is also required.
Is the salary specified for this Performance Quality Auditor position?
This information is not specified in the job description.
What is the work arrangement or location policy for this role?
This information is not specified in the job description.
What makes a strong candidate for the Performance Quality Auditor position?
Strong candidates will have a BA/BS degree, 3+ years of experience with at least 1 year in quality auditing (ideally in healthcare or insurance), and knowledge of insurance, medical terminology, relevant systems, and processing guidelines.
Elevance Health
Integrated health services and digital platform
About Elevance Health
Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.
Indianapolis, IndianaHeadquarters
1944Year Founded
$309.4MTotal Funding
IPOCompany Stage
Enterprise Software, Social Impact, HealthcareIndustries
10,001+Employees