Senior Audit Analyst
- Rancho Cordova, CA
What you'll be doing
- Demonstrates regular, reliable and predictable attendance. Conducts quality review of performance within functionally specific units of operations services for consistency with policies, procedures and any applicable regulatory guidelines. This includes review of performance of the quality review specialists to ensure equity and uniformity within the review process. Records and reports review findings as required by the functional area. The following essential duties support this responsibility: systematically collects and provides data in order to develop reports based on the quality monitoring results. Provides coaching, advice and guidance as needed. Delivers performance feedback to associates as outlined in unit's policies and procedures. Proactively identifies adverse performance trends and patterns. Provides input and recommendations to the operations services training and development associates for additional training or policy and procedure changes that may be required to enhance service and productivity. Maintains a comprehensive working knowledge of policies, procedures, and benefits across all product lines. Participates in training and mentoring for auditing staff. Provides recommendations for quality improvement and leads and/or participates in quality improvement initiatives through the formation of action teams in areas where process improvement opportunities have been identified. Coordinates workflow to ensure timeliness of review activities.
What your background should be
- Government clearance & US citizenship required. Acquired in-depth technical knowledge of functional area (claims, customer contact, or membership), typically evidenced by five years experience or any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position. In-depth knowledge of company policies, procedures and benefits across all product lines. Strong analytical and problem solving skills required. Personal computer skills and familiarity with Microsoft applications including Excel, Word and Access. Excellent verbal, written and interpersonal communication skills. Ability to interact with all levels of company. Personal organizational skills. Ability to work independently. Operates personal computers, printers, facsimile, telephones, copy machines and other commonly used office accessories/equipment. Exposed to confidential information and expected to maintain confidentiality at all times; must adhere to HIPAA rules and regulations. May be required to work outside of normally scheduled hours as mandated by the client, project and/or workload (e.g. evenings, weekends, and/or holidays). May be required to maintain established work pace, meet deadlines; may have last minute urgent requests. Twisting, reaching, kneeling, bending, stooping, squatting, crawling, grasping, grabbing, pushing, pulling, repetitive motion, climbing, etc. physical activity may require. Required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned. Required to have hearing ability to receive detailed information through oral communication. Required to have speaking ability to express or exchange ideas. Constant concentration may be required on various subjects by listening, reading and thinking clearly. Interaction with others may be required. May need to listen, think, and speak in order to interact with others. Business interactions and behavior between coworkers and/or external customers are required. This may require face-to-face or telephone interactions. Thinking at work may include listening, learning, analyzing, evaluating, and the ability to interpret what is seen and/or heard, or to link information from one issue to the next. Constant computer usage including typing and/or eye strain. Moderate amount of time spent working in a loud office environment with frequent interruptions/distractions. Constant sedentary work (desk bound or seated). Constant reading is required via computer screen and/or bound printed materials.
Required Schooling / Training
- High school diploma required. Bachelor's degree preferred.
Who is the client company
- This is an American health care insurance provider.
- If you are interested in this position, send your resume to email@example.com