Auditor (Claims)

SOUTHWEST SERVICE ADMINISTRATORS INC • Phoenix, AZ

1d • $19 - $26 • Onsite

About The Position

The Claims Auditor is responsible for all audit activities for medical and/or dental claims while supporting the team manager to create, maintain and provide statistical audit reports and documentation.

Requirements

• High School Diploma/GED
• Three (3) years recent experience analyzing medical claims
• Ability to maintain production and quality standards.
• Extensive knowledge of medical terminology, CPT Codes, ICD 9/10 and medical claim forms.
• Ability to read, analyze and assess medical documentation and draw valid conclusions.
• Minimum 40 WPM and 3,000 KPH proficiency
• Solid knowledge of MS Excel & MS Word
• Professional, client-focused approach to colleagues and assignments.
• Strong oral and written communication skills with exceptional attention to details.
• Ability to seek out experiences that may change perspective or provide an opportunity to learn new things.
• Strong dedication to follow-through on all tasks and assignments.
• Ability to organize, set priorities, work independently and complete multiple projects within established deadlines.
• Ability to sit for long periods of time operating a computer keyboard.

Responsibilities

• Auditing & Reporting Gain and maintain the understanding of the plan designs and effectively apply that knowledge.
• Maintain a comprehensive working knowledge of Policies, Procedures, Compliance Regulations, Schedule of Benefits and turnaround times across all product lines
• Research claim processing issues to determine the origin and appropriate resolution
• Prepare reports for management summarizing observations and recommendations
• Assist in testing system functionality during upgrades and implementations
• Teamwork Work cooperatively with other team members
• Actively participate in team meetings and training activities.
• Perform additional responsibilities and projects as periodically assigned.

Benefits

• MEDICAL, DENTAL, VISION
• SHORT-TERM DISABILITY
• Full coverage benefits for a low weekly premium of $5 (Employee Only), $15 (for Child(ren) and $20 per week for full family or Employee/Spouse.
• COMPANY PAID supplemental dental coverage of $1,000 per year for Employee.
• COMPANY PAID LONG TERM Disability & Life/AD&D coverage.
• 401K Plan including company match up to 5%.
• COMPANY PAID additional pension plan entirely funded by the company.
• EXCEPTIONAL TIME OFF package including Paid Personal Leave (PPL) and Vacation with annual BUY BACK options!!!!
• Annual, automatic pay increases.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 11-50 employees