Claims Auditor

Job Summary

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