Medical Claim Auditor

Job Summary

A company is looking for a Medical Claim Lead Auditor (Remote).

Key Responsibilities

• Conduct audits and document findings accurately
• Review and resolve discrepancies in claims and draft final reports
• Communicate effectively with vendors and manage project workloads

Required Qualifications

• 5+ years of experience in health claims adjudication
• Solid understanding of health and welfare plan design and claims administration
• Experience with medical, dental, mental health, and Medicare claims
• Detailed knowledge of ICD-10 and CPT codes
• Bachelor's Degree preferred; High School Diploma required