Provider Audit Professional 1 - Remote

Overview

Become a part of our caring community and help us put health first. The Provider Audit Professional 1 analyzes paid claims and reviews reports to identify discrepancies for contesting/appealing according to established procedures.

In Short

• Analyze paid claims and review reports.
• Identify discrepancies for contesting/appealing.
• Ensure correctness of delivery systems and contractual arrangements.
• Work assignments are often straightforward and of moderate complexity.
• Make decisions regarding work approach and priorities.
• Requires a Bachelor's degree and 3+ years of experience.
• Comprehensive knowledge of Microsoft Office applications.
• Strong written and oral communication skills are essential.
• Demonstrated attention to detail and accuracy.
• Must be passionate about improving consumer experiences.

Requirements

• Bachelor's degree.
• 3 or more years of healthcare / insurance claim experience.
• Comprehensive knowledge of Microsoft Office applications.
• Strong written and oral communication skills.
• Demonstrated attention to detail and accuracy.
• Proven analytical skills.
• Previous experience in audit.
• Knowledge of Compliance and/or government regulations preferred.
• Strong investigative and problem-solving skills.
• Provider experience is a plus.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability.
• Life insurance.
• Opportunities for personal and professional growth.
• Flexible scheduling options.
• Clinical certifications and leadership development programs.
• Career coaching from day one.
• Commitment to whole-person health.