Hiring: Claims Auditor Lead Company: Elevance Health Location: Atlanta, GA Job Posted Time: 2026-09-12 11:27:35 Employment Type: Hybrid Target Skills & Keywords : Microsoft Office About the job Experience: •6 years related experience in a quality audit capacity (preferably in healthcare or insurance sector); or any combination of education and experience which would provide an equivalent background. Required Skills: •The is responsible for leading the high dollar audit team within Service Operations. •Lead and oversee pre and post payment and adjudication audits of high dollar medical and pharmacy. •Lead and oversee all team training including but not limited to new hires, cross training, new product and system enhancements. •Lead and oversee creating, updating and maintaining departmental policy and claims auditor procedure manuals for accuracy. •Lead and oversee reviewing and resolving shared mailbox issues. Qualifications: •Requires a HS diploma or GED and a minimum of 6 years related experience in a quality audit capacity (preferably in healthcare or insurance sector); or any combination of education and experience which would provide an equivalent background. •Stop loss insurance experience is preferred •Proficiency in Microsoft Office Suite is highly preferred. •Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. •Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. •Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Compensation: •Flexible work environment (work from home / hybrid options) Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!