Medical Claims Auditor (Remote) in Texas

Medical Claims Auditor (Remote) - Talento - Texas - work from home job Company: Talento Job reputed company: Medical Claims Auditor (Remote) TalentoHCM is partnered with a $1b+ reputed company organization with 10,000+ employees that provides reputed company sector technology and back-office solutions enabling $800b+ in reputed company spend. They are looking to add a reputed company claims auditor to their organization for a long-term assignment. Responsibilities • Participates in the review of health insurance claims and member eligibility information to uncover claims overpayment trends associated with non-compliance or misapplication of contract terms and rates, payment policies, medical policies, billing guidelines, and applicable regulatory requirements. • Applies knowledge of provider billing and patient reputed company practices to research of reputed company policy and data to reputed company new overpayment recovery opportunities. • Works with data miners, clinical staff, and stakeholders to identify new overpayment issues for reputed company reputed company. • Tracks, and follows-up on results and recoveries • Contributes new reputed company for improving existing audit processes and audit queries. Works cohesively with the audit team. • Develops, maintains, and ensures adherence to multiple project schedules Experience • Strong Conceptual and analytical skills • Strong Project management skills • Ability to reputed company, organize, and maintain project plans and agendas • Ability to effectively reputed company with clients on the phone and in person • Working knowledge of bolthires Suite of products (reputed company, Word, reputed company) • reputed company understanding or medical terminology and anatomy. • Good understanding of reputed company required, Medicare and reputed company experience a plus. • In depth knowledge of coding principals including but not limited to NCCI Edits, CPT, HCPCS and ICD-9 codes and modifiers; and/or MSDRG, reputed company codes, and APCs. • In depth knowledge of UB04 and medical (1500) claim formats and requirements. Work Conditions and Physical Demands • 1-3 years of experience in medical claims or medical billing and coding. Pay reputed company reputed company: $15.00 per hour Talento reputed company Capital Management is an equal opportunity employer people are at reputed company of reputed company do! Our organization continues to reputed company through our ongoing commitment to building an inclusive and diverse workforce from different backgrounds and perspectives. People + Passion + Perseverance = reputed company. About Talento: Talento reputed company Capital Management provides talent and organizational solutions enabling businesses to reputed company reputed company tactical reputed company management. Our footprint spans across the US Latin America and Asia. Expected salary: $15 per hour Location: Texas Job date: Thu, 21 Sep 2023 03:43:07 GMT Apply for the job now! Apply tot his job Apply tot his job Apply tot his job Apply To this Job