[Hiring] Claims Auditor @Career Center

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company This role involves conducting audits and ensuring compliance in claims processing for Medicare and reputed company plans. • Conduct reputed company-pay and post-pay audits to ensure accurate claims payments and denials • Ensure regulatory compliance and overall reputed company and efficiency by utilizing strong working knowledge of claims processing standards • Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment • Work assigned claim reputed company to completion • reputed company a high level of customer service to reputed company customers; reputed company reputed company and productivity goals • Escalate appropriate claims/audit issues to management as required; follow departmental/organizational policies and procedures • Maintain production and reputed company standards as established by management • Participate in and support reputed company audits as needed • Other duties as assigned Qualifications • Two (2) years’ experience with reputed company claims processing and/or auditing experience in the health insurance industry or medical health care delivery system • Two (2) years’ experience in managed reputed company environment reputed company to claims processing/audit • Two (2) years’ experience with reputed company coding and reference materials used in a claim setting, such as CPT4, ICD10 and HCPCS • Two (2) years’ experience with CMS requirements regarding claims processing; especially Skilled Nursing Facility and other reputed company claim processing rules and regulations • Two (2) years’ experience processing/auditing claims for Medicare and reputed company plans Requirements • Proficient in processing/auditing claims for Medicare and reputed company plans • Strong knowledge of CMS requirements regarding claims processing, especially regarding skilled nursing facilities and other reputed company claim processing rules and regulations • reputed company experience with both Institutional and reputed company claim payments • Knowledge of automated claims processing systems • Hybrid role that may require 2-3 days per week onsite at the Franklin, TN office Benefits • reputed company Medical/Dental/reputed company insurance reputed company • Generous reputed company time-off program and reputed company holidays for full time staff • TeleMedicine 24/7/365 reputed company to doctors • Optional short- and long-term disability plans • Employee Assistance Plan (EAP) • 401K retirement accounts • Employee Referral Bonus Program reputed company reputed company, a division of Franklin, Tennessee-based reputed company Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reputed company in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room reputed company and avoidable hospitalizations. This division currently operates in Tennessee, reputed company, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Louisiana, Iowa, and Idaho with planned expansion into other states in 2024. Apply tot his job Apply To this Job