Job Description
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description As a Medical Claim Field Auditor, you will apply your medical claims audit, project management and claim processing and auditing experience to perform self-insured client audits. You will serve as a team member on audits, evaluate claims for accuracy and identify potential errors and issues. • Understand self-insured client’s plan designs • Audit claims using the administrators claims system to determine if claims were adjudicated in error • Submit error inquiries and perform research on administrators’ claim systems during the audits • Clearly communicate and professionally interact with administrator and audit team • Understand administrators’ processes, operating environment, and specific challenges and take them into account with daily work • Develop working relationship with vendor counterparts • Conduct pre-implementation and coverage specific audits and accurately document and record all audit findings • Efficiently utilize audit-specific analytic techniques, tools and processes • Ensure that Professional Excellence protocols are followed • Meet billable hours target • Seek opportunities to improve work processes and methods in pursuit of quality output and service delivery • Role will be working remotely within the posted locations Company Description Apply tot his job
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