Claims Auditor - job 1 of 3

Job Summary

A company is looking for a Claims Auditor.

Key Responsibilities

• Interact with customers to provide information regarding claims and determine coverage
• Analyze, research, and document claim issues while applying policy provisions
• Maintain compliance with industry standards and meet established performance metrics

Required Qualifications

• Knowledge of group insurance, managed care, and direct medical claims products
• Computer experience with related claims and business software
• Familiarity with COB, Medicare, HIPAA, CPT, ICD9/ICD 10, and employer group health plan benefits
• Ability to work independently while meeting production and accuracy standards
• Proficient skill level in Microsoft Office programs