Healthcare Claims Auditor
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Job Summary
Conducting claims audits for healthcare clients, the full-time remote Data Mining Auditor will review pre and post pay claims, assist in product testing, and ensure compliance with payment guidelines and regulations.
Key responsibilities
- Conduct comprehensive reviews of claims using various resources, including claims data and payment guidelines
- Serve as a claims billing and payment expert for data teams and other departments
- Develop and refine reimbursement policies and procedures in collaboration with the team
Required qualifications
- 3-5 years of experience in healthcare claims auditing, processing, or coding
- Ability to review payment information against Medicare and payer billing guidelines
- Experience or certification in coding/billing is preferred
- Proficiency in Excel, Word, Gmail, Google Sheets, and Slack
- Strong investigative and deductive reasoning skills
Complete Job Description
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