Claims Auditor

A company is looking for a Claims Auditor. Key Responsibilities Perform routine and complex audits on claims for payment integrity, ensuring compliance with regulations and policies Research claim processing errors and prepare reports summarizing findings and recommendations for management Support claims staff through technical assistance, training, and participation in performance improvement plans Required Qualifications BS/BA degree preferred with 1-3 years of experience as a medical/dental claims auditor At least 3 years of experience processing group health claims Knowledge of relevant regulations such as PPACA, HIPAA, COBRA, and ERISA Understanding of medical coding systems including CPT and ICD-10 & ICD-9 Proficient in end-user software, including word-processing and spreadsheets