Job Summary
A healthcare company is filling a position for a Telecommute Provider Claims Resolution and Recovery Auditor.
Must be able to:
- Initiate and expand recovery opportunities through provided audit results, Provider calls, Third Party Liability and CCS eligible services
- Audit payment errors that result in Provider refund checks to properly apply funds and determine the root cause
- Communicate with and answer Provider inquiries and/or Provider Disputes regarding the reason for the refund request
Position Requirements Include:
- Four (4) years claims processing experience including Medicare and Medi-Cal
- Two (2) years of experience auditing claims in a managed care environment including contract and financial DOFR interpretation
- Experience with MS Office applications
