Claims Auditor

Job Summary

A company is looking for a Claims Auditor.

Key Responsibilities

• Perform audits on claims for payment integrity and compliance with policies and regulations
• Research and resolve claim processing issues, preparing reports for management
• Provide support and training to claims staff based on audit findings and departmental needs

Required Qualifications

• BS/BA degree preferred with 1-3 years of experience as a medical/dental claims auditor
• Experience processing group health claims is preferred
• Knowledge of CPT, ICD-10, and medical terminology
• Ability to interpret summary plan descriptions and provider contracts
• Proficient in end-user software such as word processing and spreadsheets