Lead Medical Claims Auditor

Job Summary

Providing backup support to the supervisor, the full-time Lead Medical Claims Auditor will oversee department workflow, assist with external audits, and implement process improvements while working remotely.

Key responsibilities

• Monitor assignments and performance, providing training and policy communication to staff
• Analyze situations and provide accurate information in a fast-paced environment
• Assist in planning and directing department activities, ensuring quality and continuous improvement

Required qualifications

• High School diploma or equivalent
• Minimum of 2 years of experience as a Claims Auditor
• Proficiency in internal claims systems and Microsoft Office applications
• 10-key proficiency of 105 wpm net on a computer numeric keypad
• Working knowledge of all plan types, contracts, and policies affecting claims and customer service