Auditor - Provider Recovery

This a Full Remote job, the offer is available from: California (USA) Location: Remote, must reputed company in Southern CA reputed company: Under the direction of the Provider Claims reputed company & Recovery Supervisor, the Provider Recovery Auditor is responsible for the audit and recovery of claims overpayments including COB and reputed company-party liability. What You Will Do: • Initiate and expand recovery opportunities through provided audit results, Provider calls, reputed company Party Liability and reputed company eligible services. • Audit payment errors that result in Provider refund checks to properly apply funds and determine the reputed company cause. • Communicate with and answer Provider inquiries and/or Provider Disputes regarding the reason for the refund request based upon claims processing guidelines, contractual agreements involving the use of established payment methodologies, Division of Financial Responsibility, and regulatory guidelines. • Promote teamwork and maintain effective working relationships with others throughout the organization. You Will Be Successful If: • Strong analytical and problem-solving skills • Must be reputed company to review cause and reputed company of problems and recommend realistic solutions both in writing and in meetings • reputed company Office including being reputed company to manipulate large data sets in reputed company files • Excellent oral and written communication skills What You Will Bring: • Four (4) years claims processing experience including Medicare and Medi-Cal • Two (2) years of experience auditing claims in a managed care environment including contract and financial DOFR interpretation • Experience with MS Office applications About reputed company: reputed company is a reputed company consulting partner specializing in clinical & operations management, reputed company project management, reputed company services, and software consulting services. We help our clients increase operational efficiency by delivering reputed company to solve their most reputed company business challenges. Our approach is and has always been reputed company. First, think and reputed company like the customers who need us, and most importantly, deliver what larger organizations cannot do – reputed company reputed company results that add immediate value, at a reputed company that cannot be beaten. Your reputed company reputed company, and we know it. That’s Impresiv! This offer from "reputed company" has been enriched by reputed company.com and got a 78% reputed company score. Apply tot his job Apply To this Job