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Medical Claims Auditor

Remote role Full-time Open position

POSITION SUMMARY The Medical Claim Auditor (Claim Department Auditor) will be responsible for coordinating and completing audits as well as compiling and reporting results and trends accurately, appropriately, and timely. ESSENTIAL FUNCTIONS

  • Logging/Tracking all Claims/Tasks to be audited
  • Audit for accuracy as well as workflow compliance; Release of appropriate claims using established workflows
  • Assist with all audit programs currently in place as well as identifying issues for future audit programs
  • Assist with other tasks as needed and identified by Claims Management
  • Monthly meetings with Claims Management to report on audit trends and training suggestions
  • Other duties as assigned

EDUCATION

  • High School Grad or GED required

EXPERIENCE & SKILLS

  • Applicant should be proficient in the use of the Excel and Word programs.
  • Communicate effectively verbally & electronically.
  • Applicants must have 5 years of comprehensive experience with the processing or auditing of medical, dental and vision claims.
  • Applicants must have a history of excellent quality results and the desire to take on a new challenge.
  • Auditing experience is preferred, but not required.

COMPETENCIES

  • Job Knowledge
  • Time Management
  • Accountability
  • Communication
  • Initiative
  • Customer Focus

PHYSICAL DEMANDS

  • Ability to sit for long periods of time. Ability to communicate via telephone.

WORK ENVIRONMENT:

  • Remote

Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role. Protect Yourself from Hiring Scams Important Notice About Our Hiring Process To keep your experience safe and transparent, please note:

  • All interviews are conducted via video.
  • No job offer will ever be made without a video interview with Human Resources and/or the Hiring Manager.

If someone contacts you claiming to represent us and offers a position without a video interview, it is not legitimate. We never ask for payment or personal financial information during the hiring process. For your security, please verify all job opportunities through our official careers page: Current Career Opportunities at Allied Benefit Systems Your security matters to us—thank you for helping us maintain a fair and trustworthy process! Apply tot his job Apply To this Job

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