Claims Quality Auditor jobs in New Jersey

Description

The Senior Claims Auditor is responsible for evaluating audits, ensuring compliance with pre-established Procedures, Agreements, and Audit Protocol. In addition, the Senior Claims Auditor is responsible for upper level tasks such as report review and analysis, correspondence with clients and third-parties, and all other tasks assigned by the Manager. The Senior Claims Auditor must be meticulous, analytical, and have knowledge of commonly-used concepts, practices, and audit procedures. The Senior Claims Auditor works under immediate supervision in a collaborative team environment. 

Primary Responsibilities

1. Review and evaluate audits to ensure accuracy, completeness, eligibility, and compliance with procedures.

2. Conduct secondary reviews of Claims Auditors’ work and provide necessary feedback to Manager.

3. Accountable for meeting deadlines, as well as adhering to department and professional standards.

4. Allocate tasks to Claims Auditors.

5. Assist with the development of audit programs. 

6. Assist with updating and continuous improvement of processes and policy changes.

7. Assessment and analysis of audit findings and writing recommendations.

8. Prepare recommendations and higher-level analysis in the reports to clients.

9. Conduct follow-up and targeted audits to ensure implementation of recommendations.

10. Prepare client and third-party memorandums, letters, and other written communication.

11. Input on Claims Auditor training.

12. Meeting with management to discuss findings and audit outcomes.

13. Other duties as assigned.

Requirements

1. Bachelor's degree in accounting, finance, or related field.

2. Minimum of 5 years of audit experience and knowledge of auditing practices and procedures.

3. Excellent verbal and written communication skills.

4. Ability to multitask and meet deadlines.

5. Proactive approach to work tasks and forward-thinking when faced with challenges.

6. Solid problem-solving, critical thinking, and analytical skills.

7. Adaptability to changing policies, procedures, and systems.

8. Strong organizational skill and attention to detail.

9. Proficient in Microsoft Word and Excel.

WORKING CONDITIONS 

Normal business office conditions. Working for prolonged periods of time at a computer screen. Consists of in-office and remote work.