Claims Quality Audit Director directs and oversees the operations of the claims quality audit department to follow the audit policies, procedures and regulation. Provides professional knowledge and guidance on technical or procedural problems. Being a Claims Quality Audit Director creates claims audit policies and procedures. May recommend changes in claims processing procedures. Additionally, Claims Quality Audit Director typically Requires a bachelor's degree. Typically reports to top management. The Claims Quality Audit Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Claims Quality Audit Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Organization is seeking a highly skilled and experienced Director, Claims to join our team in Meridian, Idaho. As the Director of Claims, you will have overall responsibility and accountability for all aspects of healthcare claims operations. You will play a critical role in assuring timely and accurate benefit determinations for claims, while maintaining high service levels for our valued members and providers. This is a unique opportunity to make a significant impact and drive positive change within our organization.Responsibilities:
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Knowledge, Skills, and Abilities (KSAs) needed in this role:Knowledge of:
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Job Type: Full-time
Pay: $145,000.00 - $155,000.00 per year
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Work Location: In person