Claims Auditor
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Experience:
Minimum of five (5) years of Senior/Lead or Claim Audit experience in a medical claim setting. Four (4) plus years of professional and facility claims processing for Medicare and Commercial products. Must be familiar with provider dispute resolution. Knowledge of claims processing, IDC-10, CPT-4 and HCPC, IDX, Excel, Word, along with CMS and DMHC regulations for compliance. Excellent oral and written communication skills.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; sit; and use hands to finger, handle, or feel. The employee is occasionally required to reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, depth perception, and ability to adjust focus.
Minimum of five (5) years of Senior/Lead or Claim Audit experience in a medical claim setting. Four (4) plus years of professional and facility claims processing for Medicare and Commercial products. Must be familiar with provider dispute resolution. Knowledge of claims processing, IDC-10, CPT-4 and HCPC, IDX, Excel, Word, along with CMS and DMHC regulations for compliance. Excellent oral and written communication skills.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; sit; and use hands to finger, handle, or feel. The employee is occasionally required to reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, depth perception, and ability to adjust focus.