Claims Auditor

Trinityrailwayexpress

Westmont, Illinois, US
Base: $21.02 - 32.59 ph; bonus/equity: not specifi...
Fully remote
Quality auditing of claim adjudicators
Audit capitation deductions
Review claims for accuracy
Perform Quality Auditing of Claim Adjudicators and Customer Service Representatives, auditing capitation deductions and preparing summary of findings

Job Summary

  • Perform Quality Auditing of Claim Adjudicators and Customer Service Representatives, auditing capitation deductions and preparing summary of findings.
  • Review and respond to Stat Fax/Past Due Claim inquiries from HMOs, ensuring claims are processed accurately and SOPs are followed.
  • Benefit eligible (medical/dental) from the first day of employment, with a pay range of $21.02 - 32.59 per hour.

Matching Summary

Perform Quality Auditing of Claim Adjudicators and Customer Service Representatives, auditing capitation deductions and preparing summary of findings.

Salary

Base: $21.02 - 32.59 per hour; Bonus/Equity: Not specified; Benefits: Medical/dental from first day

Skills & Requirements

Must-have

  • Quality Auditing of Claim Adjudicators
  • Audit capitation deductions
  • Review claims for accuracy
  • Respond to HMO inquiries
  • Track errors and provide training

Nice-to-have

  • Enhance department productivity
  • Contribute to team effort
  • Familiarity with managed care products

Key Requirements

  • Associate Degree or 5-10 years claims auditing experience
  • Bachelor Degree preferred
  • AAPC certification preferred
  • 3-5 years previous job-related experience
  • 6-10 years previous job-related experience preferred
  • Managed care environment experience
  • Claims processing experience
  • Claims auditing experience
  • Analysis of claims errors experience

Work Rights

Not specified

Tailored Resume

Cover Letter