Claims Quality Review Consultant

A company is looking for a Claims Quality Review Consultant. Key Responsibilities Conduct Quality Assurance audits of insurance claims, ensuring accuracy, consistency, and adherence to guidelines Support senior leadership in identifying claim trends and opportunities for process improvement Participate in reviews of appeals and complaints, and draft guidelines for business process changes Required Qualifications, Training, and Education Bachelor's Degree or equivalent work experience Typically three to five years of related work experience Long Term Care Insurance experience preferred Working knowledge of claim auditing and associated business processes Proficient in Microsoft Office Suite and other business-related software systems

Mar 4, 2025 - 01:44

A company is looking for a Claims Quality Review Consultant. Key Responsibilities Conduct Quality Assurance audits of insurance claims, ensuring accuracy, consistency, and adherence to guidelines Support senior leadership in identifying claim trends and opportunities for process improvement Participate in reviews of appeals and complaints, and draft guidelines for business process changes Required Qualifications, Training, and Education Bachelor's Degree or equivalent work experience Typically three to five years of related work experience Long Term Care Insurance experience preferred Working knowledge of claim auditing and associated business processes Proficient in Microsoft Office Suite and other business-related software systems