Auditor - Provider Recovery
3 weeks ago
Overview:
**What you can expect**
Find joy in serving others with IEHP We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an **authentic experience**
Under the direction of the Provider Claims Resolution & Recovery Supervisor, the Provider Recovery Auditor is responsible for the audit and recovery of claims overpayments including COB and third-party liability.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Additional Benefits:
**Perks**
IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.
- CalPERS retirement
- 457(b) option with a contribution match
- Generous paid time off
- vacation, holidays, sick
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Paid life insurance for employees with additional options
- Short-term, and long-term disability options
- Pet care insurance
- Flexible Spending Account - Health Care/Childcare
- Wellness programs that promote a healthy work-life balance
- Career advancement opportunities and professional development
- Competitive salary with annual merit increase
- Team bonus opportunities
Qualifications:
**Education & Experience**
- Four (4) years claims processing experience including Medicare and Medi-Cal
- Two (2) years of experience auditing claims in a managed care environment including contract and financial DOFR interpretation
**Key Qualifications**
- Strong analytical and problem-solving skills
- Must be able to review cause and impact of problems and recommend realistic solutions both in writing and in meetings
- Microsoft Office including being able to manipulate large data sets in Excel files
- Excellent oral and written communication skills
Pay Range: USD $30.72 - USD $39.94 /Hr.
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