Remote Internal Claims Auditor

Overview

The Remote Internal Claims Auditor will ensure compliance with client contract criteria and requirements, perform audits on claims processing, and maintain accuracy in claims management.

In Short

• Understand client contract criteria and requirements.
• Ensure accuracy of claims processing.
• Perform targeted audits on various claims.
• Conduct quality audits of claims and eligibility staff.
• Audit new client setups in claims processing software.
• Run access queries for administrative purposes.
• Complete other assigned duties.

Requirements

• 3 years of experience in healthcare or managed care industry.
• 1-3 years of auditing experience.
• Proficiency in Microsoft Office (Word, Excel, Access).
• Problem-solving and decision-making skills.
• Understanding of healthcare compliance requirements.
• Ability to meet deadlines and prioritize tasks.
• Ability to work independently and as part of a team.
• Organizational and communication skills.

Benefits

• Fully remote work environment.
• Comprehensive Medical, Dental, and Vision plans.
• 401(k) plan with employer match.
• Life and Disability insurance.
• Employee Assistance Program (EAP).
• Flexible Time Off policy.
• Paid parental leave.
• Opportunities for professional growth and development.