Remote Medical Claims Auditor

Job Summary

A company is looking for a Remote Medical Claims Compliance Auditor.

Key Responsibilities

• Conduct routine monitoring and audits of billing systems and client procedures
• Ensure compliance with client contract criteria and generate required claims reporting
• Assist in preparing for annual Health Plan audits and monitor processes for fraud detection

Required Qualifications and Education

• 3-5 years of experience in healthcare or managed care, including claims/reimbursement
• 3 years of auditing experience in the healthcare industry
• Knowledge of CPT, ICD coding, and Medicare requirements
• Advanced proficiency in Microsoft Office products, especially Excel and Access
• Bachelor's degree in healthcare informatics, business administration, or related field preferred