Enrollment Quality Auditor

Overview HealthEdge ® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge .com. You Are HealthEdge is looking for an Enrollment Quality Auditor with health plan Medicaid member enrollment and eligibility operations experience. This role will report to the Lead Auditor or Quality Audit Manager. The Quality Auditor performs audits of an assigned group of enrollment transactions (new enrollment, disenrollment, eligibility redeterminations, PCP and plan changes, retroactive enrollment actions) and will interact with the client audit team and operational managers daily to report on audit findings, which have an impact on production and quality. This role requires the ability to work both independently with limited supervision and collaboratively in a team environment. The Opportunity Perform audits of enrollment, disenrollment, eligibility, and plan/PCP change transactions processed by health plan enrollment associates for a specific customer. Be responsible for following the customer quality process and tools for audit and rebuttal process. Rev