Claims Auditor

Working remotely in Georgia, the full-time Claims Auditor will investigate claims liability, process claims accurately according to existing policies, and communicate with clients to resolve processing issues. Key Responsibilities Review and interpret employer plans of health coverage and excess insurance policies for individual claims Audit submitted claim documents for accuracy and compliance, determining liability and setting claims reserves Communicate with third-party administrators and clients to resolve claim processing issues effectively Required Qualifications Strong medical knowledge, including ICD, CPT, medical terminology, COBRA, and HIPAA Ability to read and interpret documents such as Plan of Benefits and claim reports Advanced organizational and analytical skills with the ability to manage multiple tasks simultaneously Intermediate proficiency in Microsoft Office applications, including Excel and Word Solid written and verbal communication skills with an emphasis on confidentiality and diplomacy #J-18808-Ljbffr HCC Insurance Holdings, Inc. trading as Tokio Marine HCC