Job Summary
A healthcare company is filling a position for a Remote Medicare Part D Claims Quality Auditor in United States Minor Outlying Islands.
Candidates will be responsible for the following:
- Reviewing benefit plans to ensure that claims are being adjudicated accurately
- Documenting and reporting issues found
- Assisting with the establishment and updating of processes and audit manuals
Must meet the following requirements for consideration:
- Previous experience in managed care operations
- 1-3 years experience
- Ability to carefully follow processes in sequential order
- Knowledge of managed health care principles, benefit plans, and ERISA guidelines
- Knowledge of computer platforms and applications of Microsoft Office.
- GED or High School diploma
