Healthcare Claims Auditor
2 months ago
MedPOINT Management is seeking a skilled Healthcare Claims Auditor to join our team. As a key member of our Claims Department, you will be responsible for ensuring the accuracy and compliance of claims processes.
Key Responsibilities- Audit daily processed claims through random selection, utilizing system-generated reports to identify trends and issues.
- Conduct Claims Examiner training and document training materials and attendees.
- Research and analyze contract issues, system-related problems, and claims processing policies to recommend actions to Senior Management.
- Collaborate with other departments to ensure seamless claims processing.
- Develop and maintain Claims Department policies and procedures.
- Provide backup support for other auditors and trainers within the department.
- Perform other tasks as assigned by Senior Management.
- High School Diploma required.
- Three years of experience in a managed care claims adjudication setting, such as HMO/MSO.
- Expertise in coding structure, ICD-10, CPT-4, and Revenue Codes.
- Strong understanding of provider and health plan contracting, risk delineation, medical terminology, and standard industry reimbursement methodologies.
- Strong organizational, analytical, and communication skills.
- Proficiency in PC application skills, such as word processing and spreadsheets.
- Experience in training development and presentation.
-
Hospital Claims Auditor
1 month ago
Los Angeles, California, United States MedPOINT Management Full timeJob Title: Hospital Claims AuditorMedPOINT Management is seeking a skilled Hospital Claims Auditor to join our team. As a Hospital Claims Auditor, you will be responsible for ensuring the accuracy and compliance of claims processes in accordance with outside regulations and contractual obligations.Key Responsibilities:Audit daily processed claims through...
-
Claims Quality Assurance Specialist
3 weeks ago
Los Angeles, California, United States BroadPath Healthcare Solutions Full timeClaims Quality Auditor RoleBroadPath Healthcare Solutions is seeking a skilled Claims Quality Auditor to ensure the integrity of our claims processing system. As a Claims Quality Auditor, you will play a vital role in maintaining the accuracy and efficiency of our claims processing workflows.Key Responsibilities:Conduct thorough audits of claims processing...
-
Claims Auditor
2 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob OverviewMedPOINT Management seeks a skilled Claims Auditor to ensure the quality and accuracy of claims processes. This role involves auditing claims, researching issues, and providing feedback to improve processes.Key Responsibilities:Audit claims to ensure compliance with regulations and contractual obligations.Research and resolve issues related to...
-
Claims Auditor
2 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob SummaryA Hospital Claims Auditor is responsible for ensuring the accuracy and compliance of claims processes, adhering to regulatory requirements and contractual obligations. This role involves researching and resolving problem claims, suggesting process improvements, and providing training to staff.Key ResponsibilitiesAudit daily processed claims to...
-
Healthcare Claims Specialist
2 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob SummaryWe are seeking a skilled Healthcare Claims Specialist to join our team at MedPOINT Management. As a key member of our claims department, you will be responsible for the accurate and timely adjudication of claims, ensuring compliance with regulatory requirements and contractual obligations.Key Responsibilities:Review and analyze incoming claims to...
-
Healthcare Claims Specialist
2 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob SummaryWe are seeking a skilled Healthcare Claims Specialist to join our team at MedPOINT Management. As a key member of our claims department, you will be responsible for the accurate and timely adjudication of claims, ensuring compliance with regulatory requirements and contractual obligations.Key Responsibilities:Review and analyze incoming claims to...
-
Healthcare Claims Analyst
2 months ago
Los Angeles, California, United States MedPOINT Management Full timePosition OverviewThe role of a Healthcare Claims Analyst encompasses the evaluation and processing of claims, ensuring adherence to industry regulations and contractual obligations. This position requires investigating and resolving complex claims issues while proposing improvements to existing processes. The analyst also acts as a crucial resource for the...
-
Claims Management Director
7 days ago
Los Angeles, California, United States L.A. Care Health Plan Full timeJob SummaryThe Claims Management Director will oversee the Claims Department, ensuring compliance with regulatory requirements and maintaining high-quality claims processing. This role requires strong leadership and analytical skills, with the ability to develop and implement policies and procedures to improve claims auto adjudication.The ideal candidate...
-
Staff Auditor
2 weeks ago
Los Angeles, California, United States Consultative Search Group Full timeStaff Auditor Job DescriptionA prestigious business management firm seeks a Staff Auditor to join their dynamic team. This is an excellent opportunity for an audit professional with music industry experience.Key Responsibilities:Assist in performing royalty compliance procedures for record labels and publishers on behalf of our diverse client base.Support...
-
Staff Auditor
2 weeks ago
Los Angeles, California, United States Insight Global Full timeJob Title: Staff AuditorWe are seeking a highly skilled Staff Auditor to join our team at Insight Global. As a Staff Auditor, you will be responsible for performing payroll audits of production companies in a timely and professional manner to verify that appropriate contributions are being made in compliance with the provisions of the Trust Agreements and...
-
Healthcare Claims Specialist
2 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob Title: Hospital Claims ExaminerMedPOINT Management is seeking a highly skilled and detail-oriented Hospital Claims Examiner to join our team.Job SummaryThe Hospital Claims Examiner will be responsible for the adjudication of claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the Hospital Client. This...
-
Staff Auditor
2 weeks ago
Los Angeles, California, United States Insight Global Full timeJob SummaryWe are seeking a highly skilled Staff Auditor to join our team at Insight Global. As a Staff Auditor, you will be responsible for performing payroll audits of production companies to ensure compliance with the provisions of the Trust Agreements and Collective Bargaining Agreements of the DGA.Key ResponsibilitiesReview audit reports prepared by...
-
Risk Pool Auditor
2 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob DescriptionMedPOINT Management seeks a skilled Risk Pool Auditor to review claims paid in Shared and Dual Risk Pools, monitor and maintain audited files, and ensure accuracy and integrity of Hospital claims paid by MPM.Duties and ResponsibilitiesReview, track, and analyze Risk Pool Summaries.Audit Risk Pool Detail and submit disputes to Health Plan or...
-
Accounting Auditor
4 weeks ago
Los Angeles, California, United States Insight Global Full timeJob SummaryWe are seeking a highly skilled Accounting Auditor to join our team at Insight Global. As an Accounting Auditor, you will be responsible for performing payroll audits of production companies to ensure compliance with Trust Agreements and Collective Bargaining Agreements.Key ResponsibilitiesPerform payroll audits of production companies to verify...
-
Accounting Auditor
2 weeks ago
Los Angeles, California, United States Insight Global Full timeJob SummaryWe are seeking a highly skilled Accounting Auditor to join our team at Insight Global. As an Accounting Auditor, you will be responsible for performing payroll audits of production companies to ensure compliance with the provisions of the Trust Agreements and Collective Bargaining Agreements of the DGA.Key ResponsibilitiesPerform payroll audits of...
-
Accounting Auditor
7 days ago
Los Angeles, California, United States Insight Global Full timeJob SummaryWe are seeking an experienced Auditor for Payroll Compliance to join our team at Insight Global. As an Auditor for Payroll Compliance, you will be responsible for performing payroll audits of production companies in a timely and professional manner to verify that appropriate contributions are being made in compliance with the provisions of the...
-
Auditor
2 weeks ago
Los Angeles, California, United States CONTACT GOVERNMENT SERVICES Full timeJob Title: AuditorCONTACT GOVERNMENT SERVICES is seeking a highly skilled Auditor to provide general auditing and accounting services in support of fraud investigations involving potentially complex financial transactions and complex organizations attempting to evade detection.The ideal candidate will develop, coordinate, and draft technical audit...
-
Accounting Auditor
2 weeks ago
Los Angeles, California, United States Insight Global Full timeJob SummaryWe are seeking a highly skilled Accounting Auditor to join our team at Insight Global. As an Accounting Auditor, you will be responsible for performing payroll audits of production companies to ensure compliance with trust agreements and collective bargaining agreements.Key ResponsibilitiesPerform payroll audits of production companies to verify...
-
Accounting Auditor
7 days ago
Los Angeles, California, United States Insight Global Full timeJob SummaryWe are seeking a highly skilled Accounting Auditor to join our team at Insight Global. As an Accounting Auditor, you will be responsible for performing payroll audits of production companies in a timely and professional manner to verify that appropriate contributions are being made in compliance with the provisions of the Trust Agreements and...
-
Auditor Specialist
2 weeks ago
Los Angeles, California, United States Consultative Search Group Full timeWe are seeking a highly skilled Auditor Specialist to join our team at Consultative Search Group. This is an excellent opportunity for an audit professional with music industry experience to take their career to the next level.Key Responsibilities:Assist in performing royalty compliance procedures for record labels and publishers on behalf of our diverse...