Claims Audit Analyst

📋 Description

• Review processed claims for accuracy before payment.
• Maintain aging inventory by verifying system and claim details.
• Move error-free claims to adjudication; return errors for corrections.
• Provide feedback to Oversight & Monitoring Manager on errors and improvements.

🎯 Requirements

• 3+ years processing/auditing Medicare and Medicaid claims (professional, institutional, dental).
• Knowledge of health plan industry, CPT/HCPCS, ICD-10, and applicable regs.
• Experience with CMS and Medicaid claims preferred.
• Proficient in Microsoft Office, including Excel.

🎁 Benefits

• Medical, dental, and vision insurance.
• Generous PTO, holidays, and sick time.
• Advancement opportunities; internal promotions.
• Additional benefits provided.