Auditor (Claims)

Auditor (Claims) Apply Overview Salary Range $19.00 - $25.50 Hourly Apply Description The Claims Auditor is responsible for all audit activities for medical and/or dental claims while supporting the team manager to create, maintain and provide statistical audit reports and documentation. Responsibilities Auditing & Reporting Gain and maintain the understanding of the plan designs and effectively apply that knowledge. Maintain a comprehensive working knowledge of Policies, Procedures, Compliance Regulations, Schedule of Benefits and turnaround times across all product lines Research claim processing issues to determine the origin and appropriate resolution Prepare reports for management summarizing observations and recommendations Assist in testing system functionality during upgrades and implementations Teamwork Work cooperatively with other team members Actively participate in team meetings and training activities. Perform additional responsibilities and projects as periodically assigned. Qualifications Education/Certification: High School Diploma/GED Three (3) years recent experience analyzing medical claims Skills/Abilities: Ability to maintain production and quality standards. Extensive knowledge of medical terminology, CPT Codes, ICD 9/10 and medical claim forms. Ability to read, analyze and assess medical documentation and draw valid conclusions. Minimum 40 WPM and 3,000 KPH proficiency Solid knowledge of MS Excel & MS Word Professional, client-focused approach to colleagues and assignments. Strong oral and written communication skills with exceptional attention to details. Ability to seek out experiences that may change perspective or provide an opportunity to learn new things. Strong dedication to follow-through on all tasks and assignments. Ability to organize, set priorities, work independently and complete multiple projects within established deadlines. Ability to sit for long periods of time operating a computer keyboard. Employee Benefits Program COMPANY PROVIDES: MEDICAL, DENTAL , VISION SHORT-TERM DISABILITY Full coverage benefits for a low weekly premium of $5 (Employee Only), $15 (for Child(ren) and $20 per week for full family or Employee/Spouse. COMPANY PAID supplemental dental coverage of $1,000 per year for Employee . COMPANY PAID LONG TERM Disability & Life/AD&D coverage. 401K Plan including company match up to 5%. COMPANY PAID additional pension plan entirely funded by the company. EXCEPTIONAL TIME OFF package including Paid Personal Leave (PPL) and Vacation with annual BUY BACK options!!!! Annual, automatic pay increases.