Audit Analyst I
About The Position
6 Degrees Health is a healthcare cost containment company that uses clinical expertise and technology to support fair reimbursements and payment accuracy. The Audit Analyst I audits, verifies, and examines suspected medical, dental, and long-term-care claim overpayments identified for insurance carrier clients. The role requires a self-motivated, detail-oriented, independent professional who can review claim records and policy documents accurately and meet audit metrics. This position has no supervisory responsibilities. The position is classified as non-exempt, is Tier I, and reports to the Audit Supervisor. The stated base salary range is $16.50 to $19.00 per hour, plus benefits; individual compensation may vary based on qualifications, skills, competencies, and work location. Remote work opportunities are offered.
Requirements
- Ability to perform the essential job functions.
- Professionalism and customer/client focus.
- Written and verbal communication proficiency and excellent interpersonal skills.
- Respond positively to coaching, mentoring, and feedback.
- Problem-solving and analysis skills.
- Ability to multitask and work independently.
- Commitment to the company mission and core values.
- Attention to detail, reliability, respect, teamwork, accuracy, efficiency, and precision.
- Basic knowledge of policies and procedures.
- High school diploma or equivalent.
- Two years of experience with Microsoft Excel.
- Ability to focus on the task at hand for an entire day.
- Applicants must be authorized to work for any employer in the United States; the company cannot sponsor or take over sponsorship of an employment visa.
Nice To Haves
- Post-high-school education or certification.
- Experience reviewing dental billing, Medicare/Medicaid billing, or auditing.
- Technology proficiency, especially with computers and software applications.
- Intermediate knowledge of Microsoft Excel and Word.
- Mainframe or “green screen” experience.
- One year or more of experience with insurance claims examination or processing is highly preferred.
Responsibilities
- Verify insurance data by reviewing spreadsheets, policy documents, and systems to identify overpayments.
- Conduct detailed audits of insurance records and transactions.
- Communicate with team members to train, support, and collaborate in determining and verifying information.
- Ensure claims are reviewed and processed in a timely manner.
- Identify trends within files and provide written feedback with findings and recommendations on completed programs.
- Ensure compliance with industry standards and regulatory requirements.
- Collaborate with other departments to resolve audit findings.
- Maintain current knowledge of insurance regulations and standards.
- Respond to questions related to the assigned insurance carrier.
- Achieve daily, weekly, and monthly audit metrics.
- Maintain an average of no more than four Never Overpaid True Audit Errors per month.
- Review dental, medical, and long-term-care claims and policy documents.
- Audit Claim Voids, True Duplicates, Adjustments, US Senior Care, and Terminated Policies overpayment programs.
- Perform other duties as assigned.
Benefits
- Medical, dental, vision, and other ancillary benefits.
- Training and development opportunities.
- Nine paid holidays.
- 401(k) program with 3% employer match.
- Remote work opportunities.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
