Claims Auditor
HCC Insurance Holdings, Inc. trading as Tokio Marine HCC
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
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- ...HCC Insurance Holdings, Inc. trading as Tokio Marine HCC is seeking a full-time Claims Auditor to work remotely in Georgia. The role involves investigating claims liability, processing claims accurately, and communicating with clients to resolve issues. Key responsibilities...ClaimsFull timeRemote work
$46.99k - $122.4k
...Position Summary The Program Integrity Auditor reviews records for medical, behavioral, transportation, and other healthcare providers... ...action (provider education, recoupment of funds, rebilling of claims), and referral to state regulators for suspected fraud, waste,...ClaimsHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours$100k - $102.5k
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$115k - $125k
...Overview CopperPoint has an exciting opportunity for a Premium Field Auditor II. In this role, you will conduct medium- to large-complexity... ...monthly production targets. Verify all Workers’ Compensation claims as valid and are classified correctly for unit statistical...ClaimsHourly payTemporary workCasual workWork at officeLocal areaFlexible hours- ...Position Summary Under supervision, investigates claims liability and determines the extent of liability on a submitted claim for a specific individual. Accurately processes the claim according to the policies or contracts that exist, within the departmental time frames...ClaimsCasual workWork at officeRemote workFlexible hours
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$46.99k - $122.4k
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- ...place for a fulfilling long‑term career. Job Summary Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims. Collaborates with other Health plan departments and Management to ensure claims are processed in accordance with Federal, State...Claims
- ...Medical Billing Auditor Our client is seeking a detail-oriented, analytically strong Medical Billing Auditor to join our revenue cycle... ...: Conduct comprehensive audits of submitted claims, billing records, medical documentation, and reimbursement files...ClaimsLocal area
$42.29k
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$72.6k
...approximately 4500 payment requests annually. DDC seeks a Capital Payment Auditor to review and process these payment requisitions. To process... ...(in FMS3); and adjust payment voucher(s) due to liens, claims and assignments. The candidate will use the DDC automated ledger...ClaimsPermanent employmentFull timeFor contractors
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