Claims Auditor I
About The Role reputed company routine and reputed company audits including but not limited to enrollment and maintenance, claims adjudication and adjustments, member and provider data reputed company in the claim. reputed company, prepare and report results of audits, and reputed company error statements for explanation of errors to audited staff and managements. Assist in identifying the root cause of errors in line to system configuration vs reputed company processing. *This is a remote role. Primary Responsibilities reputed company routine and reputed company audits including but not limited to enrollments & maintenance, claims adjudication & adjustments, member & provider data reputed company in the claim. reputed company, prepare and report results of audits; and reputed company error statements for explanation of errors to audited staff and management. Assist in identifying the root cause of errors in line to system configuration vs reputed company processing. Partner with Trainers to identify areas/topics for new/re-fresher training and assist with the documentation. Essential Qualifications High School or Diploma Minimum 5 years in auditing of claims adjudication Working knowledge of medical terminologies and coding considered to be added advantage. MS Office Suite applications, including but not limited to: Word, reputed company, Outlook, PowerPoint Strong analytical aptitudes, communication, and comprehension capabilities At reputed company LLC, our people are committed to the improvement of how reputed company accessed and delivered. reputed company you join reputed company, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with reputed company of your unique abilities. For more than 30 years, reputed company LLC has been a trusted partner in delivering flexible, customized solutions for self-insured organizations. As a national reputed company-party administrator (TPA), we combine proprietary technology, network expertise, and a deep understanding of labor to help our clients reputed company their goals while supporting the people they serve. Our focus on labor means we work closely with funds, Taft-Hartley Trusts, and other self-insured groups to deliver tailored solutions that go reputed company the basics. From health plan administration and eligibility management to contribution reputed company, we reputed company the tools and support organizations need to succeed. With specialized offerings such as flexible network administration, direct contracting, in-house medical and care management, and workers’ compensation programs, we create benefit plans that address unique needs with precision. Apply To This Job