Claims Auditor

A company is looking for a Healthcare Claims Auditor.

Key Responsibilities

Ensure accurate and prompt processing of all claims in accordance with program guidelines

Perform quality audits on claims and handle escalated, high dollar or complex claims

Develop and maintain claims operations policies and procedures, and manage daily workflow for a team of processors

Required Qualifications

High School Diploma required; Associate degree preferred

Minimum of 5 years claims processing experience

Prior experience as a Team Lead or auditor

Experience in a high-volume claims operations environment

Proficiency in Microsoft Office, particularly Excel