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Claims Auditor

Personify Health

Personify Health is seeking a Senior Configuration Quality Audit Analyst to oversee end-to-end audits of complex claims configurations, ensuring accuracy against client requirements, contracts, and regulatory guidelines. You will translate SPDs and contracts into precise system rules, validate changes before go-live, and analyze claims for correct adjudication. The role emphasizes root-cause fixes, test strategy development, and cross-functional collaboration to improve automated processing. #J-18808-Ljbffr

Vacancy posted 4 days ago
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