Quality Auditor for Appeals and Grievances
A company is looking for an Appeals and Grievances Quality Auditor. Key Responsibilities Review grievances and appeals for compliance with policies, procedures, and regulatory requirements Identify issues in casework and provide feedback for corrections to colleagues Track audit findings to identify areas for quality improvement and hold meetings with department leads to discuss trends Qualifications Bachelor's degree or equivalent business experience required Minimum of 5 years of experience in Appeals and Grievances, including experience with relevant software platforms Prior experience in A&G Medicare is required Certification and licensure are not required
