Claims Auditor

Job Description

Job Description

About Delta Health Systems: Delta Health Systems is a proven leader in third-party employee benefit plan administration, delivering comprehensive self-funded health plan administration since 1968. Committed to excellence, we focus on enhancing the well-being of individuals by delivering high-quality services to our clients. We seek a dynamic Benefits & Eligibility Auditor Trainer to join our team in Stockton, California. Job Summary: Audits Claims, Customer Service and OA personnel. Key Responsibilities: · Audits work of self-funded Claims and Customer Service department for accuracy according to established procedure guidelines. · Reviews and identifies technical and system quality issues for all aspects of claim processing, corr/recon, and customer service. · Documents, maintains and reports audit statistics · Accurately interprets claim policy, procedures and standard group benefit provisions · Provides feedback to management and reviewed employees regarding quality of work · Maintains confidentiality of employee audits · Adheres to company rules and regulations. · Maintains a professional relationship and interacts with peers, subordinates, superiors in an efficient and productive manner · Performs other duties as assigned Qualifications: The requirements below represent the required knowledge, skill, and/or ability. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. The position requires considerable travel during periods. Candidate must travel to all company locations and be willing to work remotely as business needs dictate. Must be conversant in Billing and Eligibility

procedures/regulations

and proficient in Microsoft Word and Excel. Excellent written and verbal communication skills. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, policies and procedure guidelines, and training manuals. Ability to write routine reports and correspondence. Ability to speak and present effectively before groups of customers or employees and respond to questions from groups within our organization. Delta Health Systems is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Company Description Delta Health Systems, one of the leading Third Party Administrators (TPA) for self insured programs in the country with a reputation for flexibility, innovative services and outstanding customer service is looking for an innovative, self motivated, dedicated individual. Delta Health Systems offers its employees a generous and comprehensive benefits package. The health insurance components include medical, dental and vision. Additional health benefits include life insurance, disability insurance and flexible spending accounts. Other benefits include 401(k) with safe harbor contributions, vacation leave, sick leave, paid holidays, tuition reimbursement, and many more.

Company Description

Delta Health Systems, one of the leading Third Party Administrators (TPA) for self insured programs in the country with a reputation for flexibility, innovative services and outstanding customer service is looking for an innovative, self motivated, dedicated individual. Delta Health Systems offers its employees a generous and comprehensive benefits package. The health insurance components include medical, dental and vision. Additional health benefits include life insurance, disability insurance and flexible spending accounts. Other benefits include 401(k) with safe harbor contributions, vacation leave, sick leave, paid holidays, tuition reimbursement, and many more. #J-18808-Ljbffr