Claims Auditor

4 weeks ago


Los Angeles, California, United States MedPOINT Management Full time
Job Summary

A 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 Responsibilities

  • Audit daily processed claims to ensure accuracy and compliance
  • Conduct in-depth research to identify trends and recommend actions to senior management
  • Develop and implement process improvements to enhance claims processing
  • Provide training and support to staff on claims processing and regulatory requirements
  • Collaborate with other departments to ensure seamless claims processing

Requirements

  • High school diploma required
  • Three years of experience in managed care claims adjudication
  • Expertise in coding structure, ICD-10, CPT-4, and Revenue Codes
  • Strong organizational, analytical, and communication skills

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