Sr. Associate - Health Claims Quality Auditor

📋 Description

• Oversee and manage performance and service quality to guarantee customer satisfaction
• Establish and maintain communication with clients and/or team members; understand needs, resolve
• Relay important information in the form of timely and accurate reports
• Produce solid and effective strategies based on accurate and meaningful data reports and analysis

🎯 Requirements

• Understanding of standard claim forms such as CMS-1500 and UB-04
• Minimum of 2 to 3 years of direct experience in medical claims processing, medical billing, or
• Ability to spot minor billing errors, discrepancies, or potential fraud
• Strong written and verbal communication skills to report audit findings clearly
• Expert knowledge of complex commercial payer contracts, reimbursement methodologies, and federal
• Experience with process documentation