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Operations Quality Auditor (Claim)

AmeriHealth Caritas • US • published 2026-10-03 03:13:59.958585

Description

**Role Overview:** The Operations Quality Auditor is responsible for conducting timely, accurate quality reviews of operational functions, including claims processing. **Work Arrangement:** * Remote \- This position is fully remote and may be performed from any location within the United States (US), with required availability during Eastern Standard Time (EST) hours. * Associates must have access to a reliable high‑speed internet connection capable of supporting daily responsibilities, with a minimum bandwidth of 50 Mbps download and 5 Mbps upload. Fully remote associates residing in states where reimbursement is required by contract, law, or regulation may submit for appropriate expense reimbursement. **Responsibilities:** * Identify system and/or operational issues that impact the achievement of established quality performance standards. * Analyze audit results to determine root causes of errors or trends affecting quality outcomes. * Provide clear issue identification, problem analysis, and recommendations for resolution or process improvement to management. * Accurately document audit findings, trends, and observations within designated quality tracking tools. * Support qualit...

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