Auditor II - SHCN
The Auditor II conducts internal audit reviews for all medical claim forms and types to ensure accurate claims payment and secures data integrity by verifying the provider demographic information.
This position is to audit medical claims and seeks someone with claims or medical claim audit experience.
The auditor assures the quality of work within the organization by performing random quality audits of claims processed. Conducts financial accuracy audits on all claims paid greater than a value of $2,500.00. Performs audits on provider information. The Auditor II tracks and trends audit results and reports findings.
Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled
High School Diploma or GED
Certified Professional Coder preferred
Medical claims audit experience; UB-1500 claim audit experience strongly preferred
Strong Medicare / Medicaid experience