What are the responsibilities and job description for the Claims Quality Auditor position at UCLA Health Careers?
Take on a key role within a world-class, award-winning health system. Ensure the efficient delivery of award-winning patient care. Take your career in an exciting new direction. You can do all this and more at UCLA Health.
The Claims Quality Auditor serves as the primary point of contact for submission and resolution of Provider Dispute Resolutions and Appeals. They will assess and complete appropriate documentation for tracking PDR/Appeals data and conduct all pertinent research to evaluate, respond and close incoming Appeals from providers and other entities accurately, timely and in accordance with all established regulatory guidelines. The incumbent will prepare and assists with reports for the department. Additional responsibilities include:
- Reviewing claims for accuracy, appropriate application of benefits, contract interpretation and compliant with policies and procedures
- Compile and maintain statistical data consistent with department guidelines and consistently maintain production and quality standards in accordance with department policy
- Additional responsibilities may be included based on department needs
Salary : $31 - $61
