Claims Auditor
1 week ago
Position SummaryThe Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary.Specific Skills NeededKnowledge of HMO/or IPA operations; medical terminology; ICD-10, RVS, and CPT coding knowledge; knowledge of Medicare and Medi-Cal guidelines; 10-key skills by touch; excellent communication skills; knowledge of system applications; ability to function effectively under time deadlines; strong organizational skills.Required:Formal training will be indicated by a high school diploma or equivalent; four years medical claims processing.PreferredDepartment Management to list.Duties & ResponsibilitiesSafeguards and preserves the confidentiality of patient's protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies.Ensures a safe patient environment and adherence to safety practices per policy.With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care.Assist the Claims Director in the training and education of the Claims department staffCoordinate the generation and review of claims audit, status and pending claims reports ensuring authorized claims are paid in accordance with company guidelinesInvestigate, process and track payment adjustments including refunds, overpayments and underpaymentsAct as a confidential and professional resource for group providers and other staff.Act as a resource for providers, members, insurance carriers, attorneys and co-workers, researching and responding to questions in a timely mannerCreate, maintain and generate system reportsInterface with the Claims Director to ensure claims processing functions meet legal and contractual requirements with regards to health plan auditsPrepare and present weekly and monthly reports reflecting staff and departmental quality statisticsReview and audit member liability denials and Provider Dispute Resolution claims to ensure compliance with regulatory requirements and passing audit scores from health plansPerform other duties as assignedRecruiter Details:Vishakha SinghSr IT RecruiterE-mail: vishakha.singh@ustechsolutionsinc.comInternal id- 25-54852About US Tech Solutions:US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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Claims Auditor
7 days ago
Whittier, United States Pacer Group Full timeJob Title : Claims Auditor / Claims ProcessorLocation: Whittier, CAStart Date: (Immediate Start)Duration: 13 weeksSchedule Shift: Days | 7:00 AM – 3:30 PM | 8-hour days | 40-hour guaranteePay Rate: $30/hourDescription:TITLE: Claims Auditor / Claims ProcessorPIH Health Physicians is seeking an experienced Claims Auditor / Claims Processor to support the...
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Claims Auditor
7 days ago
Whittier, United States Pacer Group Full timeJob Title : Claims Auditor / Claims ProcessorLocation: Whittier, CAStart Date: (Immediate Start)Duration: 13 weeksSchedule Shift: Days | 7:00 AM – 3:30 PM | 8-hour days | 40-hour guaranteePay Rate: $30/hour Description:TITLE: Claims Auditor / Claims ProcessorPIH Health Physicians is seeking an experienced Claims Auditor / Claims Processor to support the...
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Claims Auditor
2 weeks ago
Whittier, United States US Tech Solutions Full timeJob PostingStart/end time: 7:00 am to 3:30 pm Shift: Day Next Start Date: Immediately Contract Length: 3 MonthsPosition SummaryThe Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary.Specific Skills NeededKnowledge of HMO/or IPA...
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Claims Auditor
5 days ago
Whittier, CA, United States Pacer Group Full timeJob Title : Claims Auditor / Claims Processor Location: Whittier, CA Start Date: (Immediate Start) Duration: 13 weeks Schedule Shift: Days | 7:00 AM – 3:30 PM | 8-hour days | 40-hour guarantee Pay Rate: $30/hour Description : TITLE: Claims Auditor / Claims Processor PIH Health Physicians is seeking an experienced Claims Auditor / Claims...
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Claims Auditor
2 weeks ago
Whittier, United States California Staffing Corporation Full timeClaims Auditor Position Start/end time: 7:00 am to 3:30 pm Shift: Day Next Start date: Immediately Contract length: 3 months POSITION SUMMARY The Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary. SPECIFIC SKILLS NEEDED...
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Claims Auditor
2 weeks ago
Whittier, United States US Tech Solutions Full timePosition SummaryThe Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary.Specific Skills NeededKnowledge of HMO/or IPA operations; medical terminology; ICD-10, RVS, and CPT coding knowledge; knowledge of Medicare and Medi-Cal...
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Claims Auditor
4 days ago
Whittier, United States US Tech Solutions Full timePosition SummaryThe Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary.Specific Skills NeededKnowledge of HMO/or IPA operations; medical terminology; ICD-10, RVS, and CPT coding knowledge; knowledge of Medicare and Medi-Cal...
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Medical Claims Auditor
1 week ago
Whittier, United States PIH Health Full timeThe Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers, health plan’s, providers and/or members by seeking a partnership approach that will meet the company goals and vision. The CQA auditor will coordinate Health Plan’s audits activities with preparation and provide preliminary results on...
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Claims Quality Assurance Auditor
1 week ago
Whittier, United States PIH Health Full timeClaims Quality Assurance Auditor LinkedIn Twitter Email Message Share Tracking Code26232-977Job Location6557 Greenleaf Avenue, 6557 Greenleaf Avenue, Whittier, CaliforniaCategoryBusiness Office The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers, health plan's, providers and/or members by...
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Medical Claims Auditor
3 days ago
Whittier, CA, United States PIH Health Full timeJob Description The Claims Quality Assurance Auditor maintains positive working relationships with our internal and external customers, health plan's, providers and/or members by seeking a partnership approach that will meet the company goals and vision. The CQA auditor will coordinate Health Plan's audits activities with preparation and provide preliminary...
