Insurance auditor vs auditor/quality

Differences between insurance auditor and auditor/quality duties and responsibilities

Insurance auditor example responsibilities.

• Manage the collection, analysis and verification of managerial payroll information to detect fraud and/or unethical practices.
• Prepare the audit report as prescribed by the insurance company within the time allow and within NCCI and ISO rules.
• Modify claim files upon customer request using proprietary software under strict HIPAA guidelines.
• Provide contract audit services to monitor the field sales force compliance with internal policies on promotional spending on healthcare providers.
• Audit paperwork to ensure products are produced within company and FDA specification.
• Develop and implement the recovery audit program for post-payment audit of dental Medicaid programs.
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Auditor/quality example responsibilities.

• Lead cross functional project team to build user-friendly windows base customer support applications which interface with the OmniPlan/OmniPlus mainframe application.
• Identify patterns of repetitive QMs and report to management.
• Attend Nordstrom department meetings.use RF device gun to scan merchandise, read retail report sheets.
• Complete GMP compliance audits in accordance with standards define in internal and external audit procedures and requirements.
• Complete and maintain accurate records of all quality assurance programs establish by the company and require by the FDA.
• Maintain equipment calibrations and troubleshoot laboratory equipment.
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