Remote Internal Claims Auditor

Job Summary

A company is looking for a Remote Internal Claims Auditor.

Key Responsibilities

• Ensure compliance with client contract criteria and accuracy in claims processing through internal audits
• Conduct targeted audits on various claims processing aspects, including high dollar payments and eligibility staff
• Run access queries and perform audits of new client setups in the claims processing software

Required Qualifications

• Minimum 3 years of experience in the healthcare or managed care industry, specifically in claims/reimbursement
• 1-3 years of auditing experience in the healthcare sector
• Advanced proficiency in Microsoft Office, particularly Word, Excel, and Access
• Thorough understanding of federal, state, and local healthcare compliance requirements
• Bachelor's degree in healthcare informatics, business administration, or related field is preferred