Claims Audit Analyst

A company is looking for a Claims Audit Analyst to ensure timely and accurate processing of claims while adhering to regulations and policies. Key Responsibilities Review processed claims for accuracy prior to payment and maintain acceptable levels of claims aged inventory Document audit findings, including decision methodology, system errors, and monetary discrepancies Provide feedback on claims processing errors and quality improvement opportunities to the Oversight & Monitoring Manager Required Qualifications Minimum of three (3) years of experience in processing and auditing Medicare and Medicaid claims Working knowledge of the health plan insurance industry, including CPT/HCPCS procedure codes and ICD-10 codes Experience with CMS and Medicaid healthcare claims is highly preferred Demonstrated proficiency in Microsoft Office Applications, particularly Excel