Remote Internal Claims Auditor

Overview

The Remote Internal Claims Auditor will ensure compliance with client contract criteria and perform audits on claims processing to maintain accuracy and quality in the healthcare industry.

In Short

• Understand client contract criteria and ensure compliance.
• Audit claims processing for accuracy and contract logic.
• Perform targeted audits on various claims types.
• Conduct quality audits of claims and eligibility staff.
• Audit new client setups in claims processing software.
• Run access queries for administrative purposes.
• Other duties as assigned.

Requirements

• 3+ years in healthcare or managed care industry.
• 1-3 years auditing experience in healthcare.
• Proficiency in Microsoft Office, especially Excel and Access.
• Problem-solving and decision-making skills.
• Understanding of healthcare compliance requirements.
• Ability to meet deadlines and prioritize tasks.
• Work independently and as part of a team.
• Organized, detail-oriented, and professional.
• Effective written and oral communication skills.

Benefits

• Remote work with necessary equipment provided.
• Competitive pay range.
• Opportunities for professional development.
• Diversity and inclusion in the workplace.
• Commitment to equal opportunity employment.