Job Description
Claims Auditor
We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.
The Claims Auditor performs analysis and monitors trends identified through the audit process. This individual will take the lead to ensure accurate and timely adjudication of claims, as well as identifying potential issues and recommending strategies for resolution. Apply claim and/or inquiry processing experience to audit and analyze simple to advanced-level claims processing procedures and workflows.
Job Responsibilities/Duties
Qualifications
MINIMUM EDUCATION: High School Diploma or Equivalent. BS/BA preferred.
MINIMUM EXPERIENCE: Two to three (2-3) years previous experience as medical claims Auditor or 3-5 years previous experience examining medical Claims preferred. Preferably in an IPA, MSO, or Medical Group setting.
REQ. CERTIFICATION/LICENSURE: None
Company Description
A leader in the HealthCare industry with 20 years of experience.