A company is looking for a Claims Auditor.
Key Responsibilities
Perform pre-payment and post-payment audits for claims processing accuracy and compliance
Audit and confirm the accuracy of fee schedules, provider contracts, payor contracts, and benefits
Ensure accuracy in code changes and system enhancements related to claims
Required Qualifications
High School Diploma or equivalent
5 years of experience in a medical claims processing environment
Knowledge of HMO / managed care regulatory guidelines
Experience with Epic Tapestry system preferred
3 years of experience in claim audits, revenue recovery, or claims system configuration preferred
Claims Auditor • Oakland, California, United States
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