Medical Claims Auditor

Job Summary

A company is looking for a Medical Claims Auditor to support claims operations through auditing and managing medical stop loss claim submissions.

Key Responsibilities

• Review and audit medical stop loss claim submissions for accuracy and compliance
• Facilitate financing of approved claims and collaborate with finance teams
• Maintain thorough documentation and prepare periodic reporting for stakeholders

Qualifications and Skills

• High School Diploma or GED required; Bachelor's degree preferred
• 5+ years of experience in medical claims administration
• Strong knowledge of medical terminology
• Proficiency in Microsoft Office and related software tools
• Excellent organizational and analytical skills