Audit Verifier I

Asset Protection Unit Inc•Amarillo, TX

12h•$17 - $21•Onsite

About The Position

This position is responsible for auditing and examining suspected insurance medical, dental and long-term care claim overpayments that we identify on behalf of our insurance carrier clients. To be successful in this position, you must be self-motivated, detail oriented and independent. Summary/Objective This position is responsible for auditing, verifying and examining suspected insurance for medical, dental and long-term care claim overpayments that we identify on behalf of our insurance carrier clients. To be successful in this position, you must be self-motivated, detail oriented and independent.

Requirements

Ability to perform the essential job functions
Professionalism
Communication Proficiency – written and verbal communication
Must positively respond to coaching, mentoring and feedback
Customer/Client Focus
Problem Solving/Analysis
Ability to multitask
Committed to the mission of the company
Dedicated to the core values of the company
Attention to Detail
Must exhibit high levels of communication, teamwork, professionalism, reliability, respect, etc.)
Must have a basic level of polices & procedures
High school diploma or equivalent.
Two years of experience with Microsoft Excel is required.
Possess excellent interpersonal skills, oral and written communication skills.
Be able to work independently.
Must be able to focus on the task at hand for an entire day.
Be detail oriented, accurate, efficient, and precise in completing the tasks associated with the position.
Passing of skill test will be required.
Intermediate Windows & MS Office Skills are mandatory.
To be considered for this role, please complete the Predictive Index Assessment at: https://assess.predictiveindex.com/eArRQ.
Must attend all days of onboarding training. If unable to attend all days of the training which are held in the first 30 days, the applicant will be rescheduled for the next available training. If unable to attend all days of the rescheduled training, the employee will be released from employment.
Must be regular employee who has completed their introductory period.
Cannot have any written warnings or performance improvement plans currently in place.
Problem-solving initiative in an APU role as documented by their department director and/or performance evaluations.

Nice To Haves

Post high school education or certification is preferred.
Experience reviewing dental, Medicare/Medicaid billing or auditing is preferred.
Proficiency with technology, especially computers and software applications. Have intermediate knowledge of Microsoft Excel and Word. Mainframe, “green screen” experience is preferred.
One year or more of experience with insurance claims examination or processing is highly preferred.

Responsibilities

Verifies insurance data by reviewing spreadsheets, policy documents, and systems to identify overpayments
Conducts detailed audits of insurance records and transactions
Communicate with team members to train, support, and collaborate in the determination process of verifying information
Ensures claims are reviewed and processed in a timely manner
Possesses a strong attention to detail and identifies trends within files
Provides written feedback with findings and recommendations on completed programs
Ensures compliance with industry standards and regulatory requirements
Collaborates with other departments to resolve audit findings
Maintains current knowledge of insurance regulations and standards
Responds to questions related to assigned insurance carrier
Strives to uphold the core values of APU, Be Polite, Be Persistent, and Be Proactive
Achieves daily, weekly, and monthly audit metrics
Maintains an average of no more than four Never Overpaid True Audit Errors per month
Understands how to review dental, medical and long-term claims and policy documents
Audits the following overpayment programs: Claim Voids, True Duplicates, Adjustments, US Senior Care, and Terminated Policies
Performs other duties as assigned