Insurance auditor vs quality assurance auditor

Differences between insurance auditor and quality assurance auditor 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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Quality assurance auditor example responsibilities.

• Manage post-audit activities and follow-up s on any necessary CAPA require resolving majority of deviations/investigations.
• Lead cross functional project team to build user-friendly windows base customer support applications which interface with the OmniPlan/OmniPlus mainframe application.
• Analyze and underwrite VA and FHA loans according to FNMA, FHLMC, regulatory and bank underwriting guidelines.
• Educate staff and officers of third party lending partners on procedures and requirements for FHA, VA and USDA home loans.
• Ensure loan documents are compliant with RESPA TILA guidelines.
• Prepare correspondence; including TILA and RESPA disclosures, responding to OFAC queries and other OFAC relate matters.
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