The claims auditor will be responsible for coordinating and completing audits as well as compiling and reporting results and trends accurately, appropriately, and timely.
ESSENTIAL FUNCTIONS
Logging/Tracking all Claims/Tasks to be audited
Audit for accuracy as well as workflow compliance; Release of appropriate claims using established workflows
Assist with all audit programs currently in place as well as identifying issues for future audit programs
Assist with other tasks as needed and identified by Claims Management
Monthly meetings with Claims Management to report on audit trends and training suggestions
Other duties as assigned
EDUCATION
High School Grad or GED required
EXPERIENCE AND SKILLS
At least 5 years of comprehensive experience with the processing or auditing of medical, dental and vision claims.
Auditing experience is preferred, but not required.
Must be proficient in the use of the Excel and Word programs
Excellent written and verbal communicate skills required.
COMPETENCIES
Job Knowledge
Time Management
Accountability
Communication
Initiative
Customer Focus
Physical Demand
This role requires long periods of typing, sitting, and computer work