Current jobs related to Claims Auditor - United States - Magellan Health
-
Auditor Technical Trainer
2 days ago
Indianapolis, IN, United States VirtualVocations Full timeA company is looking for an Auditor Technical Trainer for Outpatient/Specialty Audits. Key Responsibilities: Develop technical training plans, deliver training sessions, and mentor team members Assess customer/provider issues, monitor performance, and provide feedback on quality assurance controls Develop new concepts and processes, meet productivity...
-
Claim and Denials Coding Analyst
2 days ago
Allentown, PA, United States St. Luke's University Health Network Full timeSt. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other...
-
Accounts Payable Analyst
3 weeks ago
Hawthorne, NY, United States Taro Pharmaceuticals Inc Full timeProvide a brief description of the general nature of the position; an overview of why the job exists; and what the job is to accomplish. To support administrative and analyst duties for processing high volume of quarterly Medicaid invoice claims for payment timeline due of 38 days in a timely manner Duties and responsibilities Process large volume of...
-
Accounts Payable Analyst
4 weeks ago
Hawthorne, NY, United States Taro Pharmaceuticals Inc Full timeProvide a brief description of the general nature of the position; an overview of why the job exists; and what the job is to accomplish. To support administrative and analyst duties for processing high volume of quarterly Medicaid invoice claims for payment timeline due of 38 days in a timely manner Duties and responsibilities Process large volume of...
-
Accounts Payable Analyst
2 days ago
Hawthorne, NY, United States Taro Pharmaceuticals Inc Full timeProvide a brief description of the general nature of the position; an overview of why the job exists; and what the job is to accomplish. To support administrative and analyst duties for processing high volume of quarterly Medicaid invoice claims for payment timeline due of 38 days in a timely manner Duties and responsibilities Process large volume of...
-
Advanced Quality Assurance Specialist
3 days ago
, CA, United States Align Aerospace Full timeExciting Opportunity at Align AerospaceWe are seeking a highly skilled and experienced quality inspector to join our dynamic team at Align Aerospace. As an Advanced Quality Assurance Specialist, you will play a critical role in ensuring the highest standards of quality in our products and materials.Key Responsibilities:Validate and review products and...
-
Advanced Quality Assurance Specialist
4 days ago
, CA, United States Align Aerospace Full timeExciting Opportunity at Align AerospaceWe are seeking a highly skilled and experienced quality inspector to join our dynamic team at Align Aerospace. As an Advanced Quality Inspector, you will play a critical role in ensuring the quality of our products and materials, working closely with suppliers and internal departments to resolve quality-related...
-
Advanced Quality Assurance Specialist
3 days ago
, CA, United States Align Aerospace Full timeExciting Opportunity at Align AerospaceWe are seeking a highly skilled and experienced quality inspector to join our dynamic team at Align Aerospace. As an Advanced Quality Inspector, you will play a critical role in ensuring the quality of our products and materials, working closely with suppliers and internal departments to resolve quality-related...
-
Nurse Audit Lead
2 days ago
Wilmington, DE, United States Elevance Health Full timeNurse Audit Lead - Carelon Payment IntegrityAnticipated End Date: 2024-09-25 Position Title: Nurse Audit Lead - Carelon Payment Integrity Job Description: Nurse Audit Lead - Carelon Payment Integrity Location: The ideal candidate will live within 50 miles of one of our pulse point locations and will work on a hybrid work model (1-2 days per week in the...
-
San Antonio, TX, United States UnitedHealth Group Inc Full timeRegistered Nurse RN Utilization Management Quality Auditor San Antonio TexasWellMed, part of the Optum family of businesses, is seeking a Registered Nurse to join our team in San Antonio, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part...
-
Gonzales, TX, United States Optum Full timeWellMed, part of the Optum family of businesses, is seeking a Registered Nurse to join our team in San Antonio, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have...
-
San Antonio, TX, United States Optum Full timeWellMed, part of the Optum family of businesses, is seeking a Registered Nurse to join our team in San Antonio, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have...
-
Senior Indirect Tax Accountant
1 month ago
Englewood, CO, United States DISH Full timeJob Description Company SummaryDISH, an EchoStar company, has been reimagining the future of connectivity for more than 40 years. Our business reach spans satellite television service, live-streaming and on-demand programming, smart home installation services, mobile plans and products and now we are building America’s First Smart Network™.Today, our...
-
Clinical Reimbursement Manager
4 weeks ago
Lantana, FL, United States Vi Living Full timeOverview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.What We Offer:Competitive payExceptional benefitsGenerous Paid Time Off - start accruing on day one401k with company matchPaid maternity and paternity benefitsAward-winning training and...
-
Senior Indirect Tax Accountant
3 weeks ago
Englewood, CO, United States DISH Full timeCompany SummaryDISH, an EchoStar company, has been reimagining the future of connectivity for more than 40 years. Our business reach spans satellite television service, live-streaming and on-demand programming, smart home installation services, mobile plans and products and now we are building America’s First Smart Network™.Today, our brands include...
-
Senior Indirect Tax Accountant
2 days ago
Englewood, CO, United States DISH Full timeCompany SummaryDISH, an EchoStar company, has been reimagining the future of connectivity for more than 40 years. Our business reach spans satellite television service, live-streaming and on-demand programming, smart home installation services, mobile plans and products and now we are building America’s First Smart Network™.Today, our brands include...
-
Financial Controller
4 days ago
Cincinnati, OH, United States Brinks Full timeThe Brink's name is a promise to respect the trust we've earned in over 150 years in business. Every employee honors that promise by offering the highest levels of service and support to our customers. We take pride in our work, and we share a passion about our future. Learn why so many people have made the choice to join our team - and stay here. Job...
-
Financial Controller
5 hours ago
Cincinnati, OH, United States Brinks Full timeJob DescriptionThe Brink's name is a promise to respect the trust we've earned in over 150 years in business. Every employee honors that promise by offering the highest levels of service and support to our customers. We take pride in our work, and we share a passion about our future. Learn why so many people have made the choice to join our team - and stay...
-
HIM Manager of Coding HIM Full Time
3 weeks ago
Grand Rapids, MI, United States Pine Rest Christian Mental Health Svc Full timeCost CenterHealth Information ManagementScheduled Weekly Hours40Work ShiftShift & StatusWho Are We?We at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our...
-
Patient Access Manager
1 month ago
San Francisco, CA, United States Optum Full timeOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...
Claims Auditor
4 months ago
- Reviews benefit plans to ensure that claims are being adjudicated accurately and consistently according to Magellan contracts. Audits claims for financial accuracy.
- Responsible for documenting and reporting issues found.
- Assists with the establishment and updating of processes and audit manuals.
- Identifies areas where issues exist and works with appropriate individuals to ensure resolution
- Completes special focused audits as assigned by management.
- Trains and mentors new auditors; works with trainers to audit and develop trainees.
- Act as a resource for the auditing team.
Other Job Requirements
Responsibilities
An understanding of contracts, business and insurance principals related to claims adjudication.Requires ability to read and understand benefit plans.
Experience with multiple claim processing systems.
Knowledge of coordination of benefit guidelines.
An understanding of the adjustment and resolution process.
Good interpersonal skills.
Must function independently with strong organizational skills.
Ability to handle multiple accounts and priorities.
Strong verbal and written communication skills.
Minimum 1 year health claims audit experience.
General Job Information
Title
Claims AuditorGrade
20Work Experience - Required
ClaimsWork Experience - Preferred
Education - Required
GED, High SchoolEducation - Preferred
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$41,505Salary Maximum:
$62,255This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.