Claims Audit and Compliance Professional

4 days ago


San Francisco, California, United States San Francisco Health Plan Full time
About the Role:

The Claims Audit and Compliance Professional will be responsible for performing quality audits of other operational processes, providing ad hoc consultation to the Claims department, and ensuring the accurate application of managed care agreements.

This role requires strong knowledge of health care and managed care industry terms, including HCPCS, CPT, ICD-10, APR/DRG, Medical Terminology. A Bachelor's Degree with an emphasis in healthcare or business is preferred.



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