Claims Quality Auditor

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FT Hourly Full-Time Clerical Louisville, KY, US

Manhattan Life Insurance and Annuity Company was founded in 1850, the Company’s longevity makes it one of the oldest and most reliable health and life insurance companies in the country. Operating successfully for over 175 years is a testimony to Manhattan Life’s enduring history, and an indicator of the reliability of our future. Manhattan Life’s headquarters are in Houston, TX and the company is continually growing with multiple office locations nation-wide.

• Manhattan Life offers attractive employee benefits starting day one, including immediate coverage under our health, dental and vision plans.
• We offer flexible schedules, including shortened hours on Fridays, free parking, company-wide events, professional development, and a company-wide wellness program.

The Claims Quality Auditor is responsible for providing Quality Assurance of processed claims. Operational processes must be reviewed for accuracy to ensure adherence and quality output for our customers and internal partners. This role is based at our Louisville, Kentucky office.

• Audit internal paperwork and documentation as it transitions between Departments.
• Ensure Claims are processed in adherence to company policy and contract provisions.
• Ensure proper documentation accompanies all claims processed.
• Audit output of group/customer-facing documents.
• Manage all Audits, report discrepancies to case builder or leader; regression test corrections when provided.
• Assist Management in assessing and documenting process improvement areas based on quality review.
• Provide other Quality Assurance duties as needed by department.

High School Graduate or equivalent (GED); experience, education, and/or training in QA and claims processes; insurance knowledge and experience is a plus.

• 1-3 years of claims experience preferred.
• Solid knowledge of ICD-9, ICD-10 or medical coding.
• Background in insurance claims is preferred in any discipline of Medicare Supplement, Life, Health, Cancer or Disability.
• Ability to read and understand policy language.
• Understanding of basic medical terminology.
• Ability to work independently and in a team environment.
• Ability to prioritize and manage workload to meet deadlines.

This Louisville-based position does not require travel.

• Establish annual objectives for professional growth.
• Keep pace with developments in the discipline.
• Learn and apply technologies that support professional and personal growth.
• Participate in the evaluation process.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; use hands to finger, handle or feel objects, type, and use mouse;

reach with hands and arms and talk and/or hear. The employee is required to sit for extended periods of time. The position may require lifting, pulling or moving items weighing upwards of10 pounds as it relates to office or desk supplies.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee regularly works in an office environment. This role…