Quality Auditor - Enrollment (Health Plan)

Tasks

• Apply correct status attributes
• Audit health plan enrollment accuracy
• Document audit results and resolutions
• Ensure regulatory compliance
• Escalate audit issues to management
• Maintain production and quality standards
• Participate in ad hoc audits
• Perform operational quality audits
• Process assigned cases in workflow system
• Provide customer service to internal customers
• Review and correct processing errors
• Support departmental initiatives

Perks/Benefits

• 401k with employer match
• Annual bonus
• Employee recognition program
• Paid Holidays
• Paid time off
• Remote work
• Tuition reimbursement
• Wellness program

Skills/Tech-stack

Audit Processing | CMS Requirements | Case management | Excel | Health plan enrollment | Managed care | Medicaid | Medicare | Microsoft Office | Outlook | Quality Assurance | Regulatory Compliance | Teams | Word | Workflow Management