Looking to work at a firm with an unbeatable culture?
Withum is a forward-thinking, technology-driven advisory and accounting firm, helping clients to Be in a Position of StrengthSM in today’s modern business landscape.
Withum empowers clients with innovative tools and solutions to address their accounting, tax and overall business management needs.
Withum is a place where talent thrives. We recruit only the best and brightest people, with a genuine passion for the business.
Withum is seeking an experienced health claims auditor possessing in-depth knowledge of group health and disability claims procedures, medical / dental terminology, including CPT, ADA, HCPC and ICDA codes, and a thorough understanding of automated health claims systems as well as manual claims payment systems.
How You’ll Spend Your Time :
- Working closely with our clients to ensure that health, dental, prescription and vision claims are being paid in compliance with regulations and plan documents
- Reviewing client's claims adjudication internal controls policies and procedures
- Completing audit workpapers documenting procedures, findings and conclusions within assigned budgets and deadlines
- Responsible for scheduling and oversight of claims team (3-5 at any given time)
- Review work of team members and present to engagement partner for their final review
The Type's of People We Look For Have the Following Qualities :
- BS Degree
- Must be qualified at analyzing and interpreting group health insurance contract provisions and reviewing administrative policies and PPO contracts
- Experience supervising staff and working within a team environment
- Must be familiar with HIPAA and ACA compliance standards
- Must have a minimum of 7-10 years of health claims processing experience (internal auditing skills a plus)
- Good computer skills (Microsoft office preferred), excellent communication skills
- Ability to travel
- 2-4 years of managerial experience in health claims processing is a plus
The compensation for this position will vary by location. If you reside in San Ramon, CA please see below. In addition to the base compensation, Withum offers a competitive benefits package and bonus program (for eligible roles) based on individual and firm performance.
Final offer amounts are based on multiple factors such as the specific role, hiring location, as well as the individual’s skills, experience and qualifications.
For additional information on our benefits, visit our website at .
California ranges are from $90,000-$120,000 annually
New York ranges are from $90,000-$120,000 annually
Washington DC ranges are from $90,000-$120,000 annually
Withum will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or because he or she is a protected veteran.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
LI-MM1
Health Claims Audit Manager
Withum is seeking an experienced health claims auditor possessing in-depth knowledge of group health and disability claims procedures, medical/dental terminology, including CPT, ADA, HCPC and ICDA codes, and a thorough understanding of automated health claims systems as well as manual claims payment...
Senior Claims Program Manager- Medical Malpractice
Senior Program Manager- Claims. Must develop a successful rapport with facility Risk Managers and work to resolve all claims in a timely manner with them. The daily diary maintains a record of claims, reserves coverage, insurance, medical and legal issues related to any pending claims. Ability to ef...
Manager Research Project A
With mentoring from the Principal Investigator and an experienced research nurse practitioner, the Research Project Manager will be responsible for day-to-day management of complex projects conducted by the study team. The Research Project Manager will take a leadership role in managing the detailed...
Senior Roadway Project Manager
May supervise other project managers, technical professionals, and other design staff, including managing weekly project workload and manpower forecasting. This level may be achieved with ten years of experience in project production and technical professional activities, four of these working as a ...
Associate Project Manager
As an Associate Project Manager, you will manage project lifecycles from inception to close including resource scheduling, logistic coordination, cost accounting, invoicing and follow-up for small to mid-size internal and external customers. Manage all project communication with customers and Accoun...
Manager, Learning Operations
Strong project management skills, with the ability to manage multiple concurrent projects and priorities. Managing the logistics, resources, and operational support needed to execute critical projects, initiatives, and ongoing programs effectively. Bachelor's degree in project management, operations...
Manager, Research Project C (Department of Neurosurgery)
Support the development of research projects from inception to completion by providing strategic project management: assist in the development of research proposals, prepare IACUC regulatory requirements, delegate and manage tasks and project deliverables, provide documentation and reports; and deve...
Technical Project Manager- RM
Job Code - Technical Project Manager- RM. Program Manager/RTE (Release Train Engineer) experience would be excellent. Responsible for tracking and reporting on project/program level. Project or Program Management experience are a must have. ...
Senior Project Manager
Colliers Engineering & Design is seeking a Senior Project Manager that is team-focused, innovative and results-oriented self-starter to assist in expanding our Traffic Planning Discipline in our Philadelphia, PA office. The Senior Project Manager will utilize leadership and engineering skills to per...
Mechanical Project Manager
As the HVAC Construction Project Manager, you will be responsible for overseeing all aspects of HVAC construction projects from inception to completion. Greater Philadelphia Area HVAC mechanical construction contractor is seeking a highly skilled Commercial HVAC Project Manager to join their team. P...