Medical Claims Auditor

VirtualVocations
Irving, Texas, United States
Full-time
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  • A company is looking for a Medical Claims Auditor to audit and adjudicate stop loss insurance medical claims.Key ResponsibilitiesReview and audit medical stop loss claim submissions against relevant documents and standardsCompile periodic reporting for internal and external parties, and advise on claim projectionsRecognize and document trends in claims, providing ongoing feedback for quality improvementRequired Qualifications and EducationHigh School Diploma or GED required;
  • Bachelor's degree in Medical Billing and Coding or related field preferred5+ years of experience in medical claims administration;

understanding of Third Party Administration functions preferredKnowledge of medical terminology requiredWorking knowledge of Microsoft Office productsExperience with self-quality monitoring and executing plans to meet established goals

5 days ago
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