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 procedures related to billing systems and client audits
• Ensure compliance with client contract criteria and generate required Commercial claims reporting
• Assist in preparing for annual Health Plan audits and monitor processes to detect fraud or abuse

Required Qualifications

• 3-5 years of experience in healthcare or managed care, including claims/reimbursement and project management
• 3 years of auditing experience in the healthcare industry
• Knowledge of CPT and ICD coding, Medicare requirements, and APC Pricing
• Advanced proficiency in Microsoft Office products, especially Word, Excel, and Access
• Ability to work independently and as part of a team while meeting deadlines and prioritizing tasks