Claims Quality Auditor
3 weeks ago
Claims Quality AuditorTake on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract interpretation, Division Of Financial Responsibility (DOFR), and application/compliance with policies and procedures. You will:Research over and under-payment inquiries/appealsCompile and maintain statistical data consistentMaintain departmental production and quality standardsSalary Range: $31.51 - $62.64 HourlyQualifications: We're seeking a self-motivated, detail-oriented, deadline-driven individual with:High school diploma, GED or equivalentFour or more years of medical claims payment experience in an HMO environmentExperience with CPT-4, ICD-9CM, RBRVS, ASA, and HCPCSUnderstanding of Medicare Guidelines and COBKnowledge of medical terminologyExperience in benefit determination and claims adjudicationAbility to accurately key 6,000-8,000 keystrokes or type 40-50 WPMUnderstanding of professional and facility reimbursement methodologiesStrong organizational skillsComputer proficiency with Microsoft OfficeKnowledge of claims adjudication systemsFlexibility and adaptabilityUCLA Health is a world-renowned health system with four award-winning hospitals and more than 250 community clinics throughout Southern California. We are also home to the David Geffen School Of Medicine, a highly respected leader in the development of breakthrough medical research and outstanding clinical professionals. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health. UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person's unique achievements and experiences to further set us apart.
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Claims Quality Auditor
6 days ago
Los Angeles, United States UCLA Health Full timeClaims Quality AuditorThe Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract interpretation, Division of Financial Responsibility (DOFR), and application/compliance...
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Claims Quality Auditor
3 weeks ago
Los Angeles, United States University of California - Los Angeles Health Full timeDescriptionTake on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health.The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the...
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Claims Auditor
9 hours ago
Los Angeles, United States ProKatchers LLC Full timeJob Title : Claims AuditorLocation : Los Angeles, CA 90017(Remote)Duration : 21 weeksJob Description:The Specialty Health Plans Auditor III, Claims is responsible all aspects of planning, execution, reporting, and corrective action plans monitoring of claims processing compliance for specialty health plans and vendors. Essential Duties and...
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Claims Auditor
6 days ago
Los Angeles, United States ProKatchers LLC Full timeJob Title : Claims AuditorLocation : Los Angeles, CA 90017(Remote)Duration : 21 weeksJob Description:The Specialty Health Plans Auditor III, Claims is responsible all aspects of planning, execution, reporting, and corrective action plans monitoring of claims processing compliance for specialty health plans and vendors. Essential Duties and...
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Claims Auditor
6 days ago
Los Angeles, United States ProKatchers LLC Full timeJob Title : Claims AuditorLocation : Los Angeles, CA 90017(Remote)Duration : 21 weeksJob Description:The Specialty Health Plans Auditor III, Claims is responsible all aspects of planning, execution, reporting, and corrective action plans monitoring of claims processing compliance for specialty health plans and vendors. Essential Duties and...
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Claims Auditor
6 days ago
Los Angeles, CA, United States ProKatchers LLC Full timeJob Title : Claims Auditor Do you have the following skills, experience and drive to succeed in this role Find out below. Location : Los Angeles, CA 90017(Remote) Duration : 21 weeks Job Description: The Specialty Health Plans Auditor III, Claims is responsible all aspects of planning, execution, reporting, and corrective action plans monitoring of claims...
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Medical Claims Auditor
6 days ago
Los Angeles, CA, United States ProKatchers LLC Full timeJob Title : Claims Auditor Location : Los Angeles, CA 90017(Remote) Duration : 21 weeks Job Description: The Specialty Health Plans Auditor III, Claims is responsible all aspects of planning, execution, reporting, and corrective action plans monitoring of claims processing compliance for specialty health plans and vendors. Essential Duties and...
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Claims Appeal Auditor
2 weeks ago
Los Angeles, CA, United States Century Group Full timeCentury Group is partnering with a client who is seeking a Claims Appeal Auditor. Exact compensation may vary based on skills, experience, and location. Expected starting base salary $22.50 to $24.50 per hour. Essential Duties and Responsibilities include the following: Provide reports and on-going updates to Claims management Assist in the processing of...
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Claims Appeal Auditor
1 week ago
Los Angeles, CA, United States Century Group Full timeCentury Group is partnering with a client who is seeking a Claims Appeal Auditor. Exact compensation may vary based on skills, experience, and location. Expected starting base salary $22.50 to $24.50 per hour. Essential Duties and Responsibilities include the following: Provide reports and on-going updates to Claims management Assist in the processing of...
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Financial Compliance Auditor III Claims
4 weeks ago
Los Angeles, United States LOS ANGELES CARE HEALTH PLAN Full timeFinancial Compliance Auditor III ClaimsEstablished in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care...
