Find out the top 10 core skills you need to master as a claims quality assurance auditor and what hard skills you need to know to succeed in this job.

A Claims Quality Assurance Auditor is accountable for ensuring that the quality control systems put in place for claims are conforming to both internal and external standards. This position is carried out as part of the internal control team in the eh company or as independent contractors for auditing firms.

Their duties include overseeing of all claims and ensuring compliance with the organizational, state and federal policies, identifying any issues in the he data quality, sourcing or documentation that may pose a risk to the company by reviewing existing data and processes, reading, analyzing and interpreting existing documents and data for completeness and accuracy, creating recommendations for training new policies and data scrubbing and any other methods to resolve data quality concerns.

Core Skills Required to be a Claims Quality Assurance Auditor

Core skills describe a set of non-technical abilities, knowledge, and understanding that form the basis for successful participation in the workplace. Core skills enable employees to efficiently and professionally navigate the world of work and interact with others, as well as adapt and think critically to solve problems.

Core skills are often tagged onto job descriptions to find or attract employees with specific essential core values that enable the company to remain competitive, build relationships, and improve productivity.

A claims quality assurance auditor should master the following 10 core skills to fulfill her job properly.

Verbal Communication:

Verbal Communication is the use of tones and language to relay a message; it aids as a vehicle for expressing ideas, concepts and it, is critical to the daily running of the business.

A Claims Quality Assurance Auditor portrays his/her image and that of the company by the way he/she communicates; strong verbal communication skills are vital for business development and forging lasting relationships with customers, suppliers, and colleagues.

Interpersonal Skills:

Interpersonal Skills are a set of abilities that enable a person to positively interact and work with others effectively while avoiding office disputes and personal issues with each other.

A Claims Quality Assurance Auditor must learn the importance of these skills in the workplace and emphasis on every employee possessing them to build a more cohabit able and productive workplace with the help of each.

Giving Feedback:

Giving Feedback is one of the most powerful tools to develop employees and improve performance through honest feedback of the work done best and areas that need improvement.

A Claims Quality Assurance Auditor should be skilled in giving out both praise and criticism in a wise way to occasionally show workers where they need to improve and providing them with an observer's insight into the progress of their performance.

Leadership Skills:

Leadership Skills are soft skills that assist leaders in positively interacting with employees or team members to make the workplace a great place.

A Claims Quality Assurance Auditor must be able to lead effectively by learning how to deal with all types of people in a way that motivates, enthuse and build respect in a bid to understand and develop his leadership skills.

Creativity:

Creativity is the skill of turning new and imaginative ideas into reality through the ability to perceive the world in new ways, find hidden patterns, make connections between unrelated phenomena and generate solutions.

A Claims Quality Assurance Auditor should be able to think, then reproduce ideas and act on them to bring awareness of what was currently hidden and point to a new life that will progress the business to new heights.

Dedication to Work:

Dedication to Work is a devotion or setting aside the scheduled time that you are required to work each day consistently without fail as well as being on time and giving 100% of your efforts to doing quality work.

A Claims Quality Assurance Auditor ought to be dependable and set an example for the rest of the workforce by showing up for work on time every day consistently and producing quality work while applying company policies and business strategies.

Dependability:

Dependability is the characteristic of being able to be counted on and relied upon by providing services that be trusted within a period.

A Claims Quality Assurance Auditor needs to be dependable and hire reliable employees who can be counted on as consistent and beneficial to the business, building their niche as an essential element of the larger team without worrying about bringing less than your efforts.

Potential for Advancement:

The potential for Advancement is the ability to make something better by being more skillful, more efficient, and more useful to produce high-quality results.

A Claims Quality Assurance Auditor needs to invest in his employees by creating room for individual advancement that encourages stronger job performance because it positions the employees to demonstrate just how well they can perform their jobs through motivation and feedback that are critical to the employee performance.

Quality Management:

Quality Management is the management approach to the long-term success through customer satisfaction that directly involves the employees in the continual improvement of the daily tasks.

A Claims Quality Assurance Auditor should consider the quality management earnestly for the success of the business by improving the processes, products, services, the discipline and the culture in which they work under to warrant the improvement of profitability and productivity.

Business Etiquette:

Business Etiquette is a basic framework of rules set by companies to ensure and allow you to understand the way you should conduct yourself in the professional world.

A Claims Quality Assurance Auditor must establish the tone for proper behavior in the workplace by making sure all the distinct boundaries are laid out for everyone to follow and understand the implications of defaulting.

Hard Skills Required to be a Claims Quality Assurance Auditor

Hard skills are job-specific skill sets, or expertise, that are teachable and whose presence can be tested through exams. While core skills are more difficult to quantify and less tangible, hard skills are quantifiable and more defined.

Hard skills are usually listed on an applicant's resume to help recruiters know the applicant's qualifications for the applied position. A recruiter, therefore, needs to review the applicant's resume and education to find out if he/she has the knowledge necessary to get the job done.

A claims quality assurance auditor should have a good command of the following hard skills to succeed in her job.

Claims Quality Assurance Auditor: Hard skills list

Accounting
Administration
Auditing
Bookkeeping
Business Acumen
Clerical
Computers and Electronics
Corporate Finance
Customer and Personal Service
Data Interrogation
Data Mining and Analytics
Documentation
Economics
Ethical
Financial
Financial Software
Fraud Auditing
Finance
Forensic
Information Security Management
IT
Industry-Specific Knowledge
Information Technology
Internal Auditing
Interpersonal
Investigation
Legal Compliance
Legal Knowledge
Marketing
Mathematics
Methodology
Occupational Health and Safety Management
Presentation
Quality Controls
Quality Management
Reporting
Reporting Research Results
Risk and Compliance Expertise
Risk Management Assurance
Sales
Security, Emergency, and Continuity Management
SFAS Rules
Statistics
Technical
Theory
Transportation Safety Management
Writing

Related Articles