Claims QA Auditor – Lead

Centivo

full-time

Posted on: 2/7/2026

Location Type: Remote

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💰 $65,000 - $70,000 per year

About the role

Oversight and management of the Claims Quality Assurance Team, including mentoring the team, implementing and coaching through performance improvement plans, and training auditors on job performance expectations.
Reviewing audits of claims, ensuring processing accuracy by verifying all aspects of the audit have been handled correctly and according to both standard processes and the Client’s summary plan description.
Managing the inventory of audits against standard service level agreements (SLA’s) and reporting requirements.
Compiling reporting of audits completed, with decision methodology for procedural and monetary errors which are used for quality reporting and trending analysis utilizing quality tools.
Identifying trends based on the quality reviews, identifies quality improvement opportunities and partners with training team to develop programs.
Partnering with Claims Department Leadership and Training Lead on any problematic issues warranting immediate corrective action.

High School diploma or GED required, Associate or Bachelor’s degree preferred.
Minimum of three (3) years of experience in a claim examiner or quality assurance role with a health care company, meeting production and quality goals/ standards.
Detailed knowledge of relevant systems and proven understanding of processing principles, techniques, and guidelines.
Proficient experience in MS Word, Excel, Outlook, and PowerPoint.

Benefits

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

claims auditingquality assuranceperformance improvementtrend analysisprocessing accuracydecision methodologyquality reportingquality improvement

Soft Skills

mentoringcoachingtrainingproblem-solvingcollaboration

Certifications

High School diplomaGEDAssociate degreeBachelor's degree