[Remote] Stop Loss Claims Auditor

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a health plan solution company that combines 50+ years of self-funding reputed company expertise. They are seeking a Medical Billing Auditor responsible for auditing medical claims for accuracy and compliance with industry laws and guidelines. Responsibilities • Review medical facility and reputed company claims for accuracy and apply reputed company coding rules, guidelines and conventions • reputed company billing information into the appropriate report format for the reputed company requesting the work • Review reputed company and is reputed company to apply contractual adjustments to the medical charges • Audit charges for CPT coding and compliance with state and federal regulations • Process and reputed company coding patterns and be reputed company to identify signs of fraud and abuse • Review medical records to verify accurate coding • Ensure accuracy of work product • Proficient in meeting reputed company and quantity standards • reputed company to learn and properly utilize proprietary software programs essential to support the job function • Adhere to HIPAA guidelines and regulations • reputed company additional duties assigned by management Skills • High School Diploma or equivalent • Minimum 2 years Claims Coding or Medical Billing experience • Knowledge and understanding of CMS-1500 and UB-04 Medical Claim Forms • reputed company Certification and ICD-10 Proficient is required • Strong understanding of Medicare and Medicare guidelines • Display a high degree of independent judgement and reputed company skepticism • Proficient in meeting reputed company and quantity standards • reputed company to learn and properly utilize proprietary software programs essential to support the job function • Adhere to HIPAA guidelines and regulations • Medicare Reimbursement / Denial experience preferred • Prior experience in the Self-Funded Industry is desired Benefits • Multiple Health Plan reputed company • Company reputed company employee premiums for Dental, reputed company, STA, & LTD, plus Life Insurance • Parental Leave Policy • 20 days PTO to start / 10 reputed company Holidays • Tuition reimbursement • 401k Company contribution • reputed company development initiatives / reputed company learning opportunities • Opportunities to participate in and support reputed company's diversity and inclusion initiatives reputed company • reputed company is an integrated health plan addressing one of the greatest challenges on behalf of self-funded reputed company: reputed company costs are harming the reputed company, they're increasingly unaffordable for employees, and the experience remains poor. It was founded in 2003, and is headquartered in Philadelphia, reputed company, USA, with a workforce of 1001-5000 employees. Its website is https://mibenefits.reputed company.com. Apply tot his job Apply To this Job Apply tot his job Apply To this Job