What are the responsibilities and job description for the Quality Assurance Auditor, Advanced (Healthcare Claims) position at Blue Shield of CA?
Your Role
The Medi-Cal Claims Operations team is responsible for ensuring claims are processed accurately and timely. The Quality Assurance Auditor, Advanced will report to the Medi-Cal Operations Manager. In this role you will be responsible for performing audits that are routine in nature for the Medi-Cal line of business for all claim types.
Your Knowledge and Experience
- Requires a high school diploma or GED
- Requires at least 5 years of prior relevant experience
- Minimum 5 years previous claims processing experience of all medical claim types
- Knowledge of DHCS guidelines preferred
- Prior auditing experience preferred
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
