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Health Claims Auditor
2 months ago
We are seeking an experienced Health Claims Auditor to join our team at Withum. As a Health Claims Auditor, you will play a critical role in ensuring that health, dental, prescription, and vision claims are being paid in compliance with regulations and plan documents.
Key Responsibilities:
- Work closely with clients to ensure compliance with regulations and plan documents
- Review client's claims adjudication internal controls policies and procedures
- Complete audit workpapers documenting procedures, findings, and conclusions within assigned budgets and deadlines
Requirements:
- BS Degree
- Qualified to analyze and interpret group health insurance contract provisions and review administrative policies and PPO contracts
- Experience working within a team environment
- Familiar with HIPAA and ACA compliance standards
- Minimum of 2-4 years of health claims processing experience (internal auditing skills a plus)
- Good computer skills (Microsoft Office preferred), excellent communication skills
- Ability to travel
What We Offer:
Withum offers a competitive benefits package and bonus program (for eligible roles) based on individual and firm performance. Final offer amounts are based on multiple factors such as the specific role, hiring location, as well as the individual's skills, experience, and qualifications.
We are an equal opportunity employer and welcome applications from diverse candidates. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Remotely anywhere within the United States except the States of Colorado & New York.
