Claims Quality Auditor jobs in Normal, IL

Claims Quality Auditor audits claims for coding accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Selects claims through random processes and/or other criteria. Being a Claims Quality Auditor makes recommendations to improve quality, workflow processes, policies and procedures. Typically requires an associate degree. Additionally, Claims Quality Auditor typically reports to a supervisor or a manager. The Claims Quality Auditor gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Claims Quality Auditor typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Auditor
  • Contact Government Services, LLC
  • Peoria, IL FULL_TIME
  • Auditor

    Employment Type: Full-Time, Mid-Level

    Department: Financial


    CGS is seeking a highly skilled Auditor to provide general auditing and accounting services in support of fraud investigations involving potentially complex financial transactions and complex organizations attempting to evade detection. The ideal candidate will develop, coordinate, and draft technical audit guidelines, is proficient in a variety of accounting systems, and practices excellent cross-functional communication throughout investigations.


    CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities.

     

    Skills and attributes for success:

    -         Analyze and audit a variety of accounting systems.

    -         Analyze, organize, and present a large volume of data such as bank records, financial records, healthcare claims, tax records, correspondence, policies, other documentary evidence, etc., through the use of common software programs.

    -         Assist with the planning of investigations, including performing quantitative and qualitative analyses to identify potential witnesses and relevant financial documents.

    -         Prepare concise and accurate reports of results of analysis, including detailed charts, summaries and schedules as necessary.

    -         Assist with conferences and interviews of representatives of financial institutions, Certified Public Accountants, and other potential witnesses to financial activities.

    -         Utilize electronic databases to identify assets, documents, and other physical evidence.

    -         Analyze an individual or corporation’s ability to pay monetary penalties based on financial disclosures and independent investigation of assets and liabilities.

    -         Perform ancillary investigation-related services in support of assigned cases as follows:

    -         Develop, coordinate and issue draft technical audit guidelines and instructions applicable to financial audits and investigations.

    -         Prepare interim and final reports throughout the investigation process for use by staff members.

    -         Arrange for secure storage, preservation, organization and indexing of voluminous documentary evidence.

    -         Assist in the compilation and analysis of documents and physical evidence, and the creation of charts, graphs, and other audio-visual materials for use in motions and at trial.

    -         Meet with the designated federal agency personnel, state and local officials as needed throughout investigations.

    -         Other related duties as assigned and within scope.x


    Qualifications:

    -         Four-year undergraduate degree or higher in statistical/data analysis, finance, accounting, fraud examination, or other related field.

    -         Minimum 3 years of professional work experience in finance, accounting, fraud examination or statistical/data analysis.

    -         Proficient in Microsoft Office applications including Word, Excel, PowerPoint, Access, etc.

    -         U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.

    -         Experience and expertise in performing the requisite services in Section 3 Preferred qualifications:

    -         Experience reviewing and understanding medical records and knowledge of medical billing procedures, including experience using STARS and/or Business Objects.

    -         Relevant experience working with a federal or state legal or law enforcement entity.

     

    Our Commitment:

    Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting-edge technology with world-class personnel to deliver customized solutions that fit our client’s specific needs. We are committed to solving the most challenging and dynamic problems.


    For the past seven years, we’ve been growing our government-contracting portfolio, and along the way, we’ve created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work.


    Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come.


    We care about our employees. Therefore, we offer a comprehensive benefits package.

    -         Health, Dental, and Vision

    -         Life Insurance

    -         401k

    -         Flexible Spending Account (Health, Dependent Care, and Commuter)

    -         Paid Time Off and Observance of State/Federal Holidays


    Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.


    Join our team and become part of government innovation!


    Explore additional job opportunities with CGS on our Job Board:

    https://cgsfederal.com/join-our-team/


    For more information about CGS please visit: https://www.cgsfederal.com or contact:

    Email: info@cgsfederal.com

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  • 3 Days Ago

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Quality Inspector
  • TRIGO Global Quality Solutions
  • Mossville, IL FULL_TIME
  • TRIGO Global Quality Solutions has several immediate openings for Quality Inspectors in Mossville, IL Reports to Site Supervisor/Site Leads Quality Inspector Responsibilities (To include but not limit...
  • 1 Month Ago

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Quality Inspector/ 1st Shift
  • TRIGO Global Quality Solutions
  • Mossville, IL FULL_TIME
  • TRIGO Global Quality Solutions is seeking 1st shift Quality Inspectors for our Mossville, IL location. Schedule: 1st shift (7am-3:30pm) Monday to Friday 40 hours per week Work Location: Mossville, IL ...
  • Just Posted

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Quality Inspector-Part Time
  • TRIGO Global Quality Solutions
  • Peoria, IL PART_TIME
  • TRIGO Global Quality Solutions has several immediate openings for Quality Inspectors in Mossville, IL. (Partime) Reports to Site Supervisor/Site Leads Quality Inspector Responsibilities (To include bu...
  • Just Posted

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Quality Inspector/ 2nd Shift
  • TRIGO Global Quality Solutions
  • Mossville, IL FULL_TIME
  • TRIGO Global Quality Solutions has several immediate openings for Quality Inspectors in Mossville, IL. Reports to Site Supervisor/Site Leads Quality Inspector Responsibilities (To include but not limi...
  • 3 Days Ago

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Quality Inspector-HT
  • TRIGO Global Quality Solutions
  • Mossville, IL FULL_TIME
  • TRIGO Global Quality Solutions has several immediate openings for Quality Inspectors in Mossville, IL. Reports to Site Supervisor/Site Leads Quality Inspector Responsibilities (To include but not limi...
  • 4 Days Ago

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0 Claims Quality Auditor jobs found in Normal, IL area

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Associate Director, Digital
  • NOVUS
  • Bloomington, IL
  • WHY WORK AT NOVUS: We Bring Brands To Where People Live Their Lives. NOVUS is an independent local media planning and bu...
  • 4/23/2024 12:00:00 AM

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Account Manager, Industrial Starch Sales
  • Primient
  • Clinton, IL
  • Account Manager, Industrial Starch Sales Midwest Ready for a Sales career with more impact ? Join a market leader in ing...
  • 4/23/2024 12:00:00 AM

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Account Manager, Industrial Starch Sales
  • Primient
  • Lincoln, IL
  • Account Manager, Industrial Starch Sales Midwest Ready for a Sales career with more impact ? Join a market leader in ing...
  • 4/23/2024 12:00:00 AM

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Quality Assurance Specialist
  • Sterling Engineering
  • Bloomington, IL
  • Job Summary: As the Quality Product Specialist you will uphold the integrity and top-notch quality of all of our product...
  • 4/22/2024 12:00:00 AM

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Sous Chef
  • Normal Marriott
  • Normal, IL
  • Hotel: Normal Marriott Sous Chef Full time Atrium SPIRIT – where teamwork, passion and appreciation ignite service excel...
  • 4/22/2024 12:00:00 AM

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Quality Product Specialist - 1st Shift Kinder Bueno
  • Ferrero
  • Bloomington, IL
  • Company Description: Ferrero is a family-owned company with a truly progressive and global outlook and iconic brands suc...
  • 4/22/2024 12:00:00 AM

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Product Quality Inspection Technician
  • Philips
  • Latham, IL
  • Job Title Product Quality Inspection Technician Job Description Product Quality Inspection Technician is responsible for...
  • 4/22/2024 12:00:00 AM

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Sous Chef
  • Atrium Hospitality
  • Normal, IL
  • Hotel: Normal Marriott Sous Chef Full time Atrium SPIRIT - where teamwork, passion and appreciation ignite service excel...
  • 4/21/2024 12:00:00 AM

Normal is a town in McLean County, Illinois, United States. As of the 2010 census, the town's population was 52,497. Normal is the smaller of two principal municipalities of the Bloomington–Normal metropolitan area, and Illinois' seventh most populous community outside the Chicago metropolitan area. Normal's mayor is Chris Koos. The main campus of Illinois' oldest public university, Illinois State University, a fully accredited four-year institution, is in Normal, as is Heartland Community College, a fully accredited two-year institution. There is also a satellite campus of Lincoln College, w...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Auditor jobs
$44,002 to $53,932
Normal, Illinois area prices
were up 1.3% from a year ago

Claims Quality Auditor in Bloomington, IN
Evaluates claims activities of other departments and / or companies.
December 05, 2019