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For your reference, we have included the original job posting below.
Claims Auditor
Job Number:
41668925
Company Name:
Helpmates Staffing Services
Job Location:
Cerritos, CA US
Job Category:
Management & Business
Claims Auditor
Position: Claims Auditor Location: Cerritos Date Posted: 12/27/2011 Pay Rate: $20.00-$22.00 per hour Job Number: Claims-Med1 Description: An excellent company near the city of Cerritos is looking for an experienced Claims Auditor for a temporary assignment. The Claim Auditor will be responsible for monitoring claims compliance by generating daily reports as well as daily auditing of managed care claim payments.
Duties for the Claims Auditor will include but not be limited to the following:
· Will act as the liaison with internal and external clients to resolve provider/member claim issues. * Perform daily audits of claims payments as established in the Claims Department Policies and Procedures. * Log all totals related to claims payment errors and examiner productivity for reporting purposes as established in the Claims Policies and Procedures. * Train claims examiners regarding the system and claim procedures as needed * To review claims denial letters prior to issuing. * Audit check runs and perform check payment process. * Run daily claims report to monitor claims compliance. * Manage the HMO claims deduct process. * Track and generate request for claims overpayment. * Prepare information needed for health plan audits. * Serve as a resource to customer service, UM and other departments on claim issues as needed * To perform other duties as directed.
Pay: $20.00-$22.00 per hour, depending on experience
Schedule: Monday through Friday, 8:30am – 5:00pm
Eligible candidates must meet all of the following requirements to be considered for the Claims Auditor position: * Must have extensive knowledge in the area of managed care claims, with specific knowledge of CMS guidelines, as is generally acquired by at least 4 years of experience as a Claims Auditor. * Must have excellent follow-up skills * Must be able to meet deadlines while working in a fast paced, high stress environment * Must have excellent communication skills (verbal and written) * Must be proficient in Microsoft office programs (Word/Excel/Outlook) * Must be able to pass a criminal background check and drug screen Category: Healthcare Length: Temporary
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