[Hiring] Claims Auditor @DELTA HEALTH SYSTEMS MCC

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description • Audits work of self-funded Claims and Customer Service department for accuracy according to established procedure guidelines. • Reviews and identifies technical and system quality issues for all aspects of claim processing, corr/recon, and customer service. • Documents, maintains and reports audit statistics. • Accurately interprets claim policy, procedures and standard group benefit provisions. • Provides feedback to management and reviewed employees regarding quality of work. • Maintains confidentiality of employee audits. • Adheres to company rules and regulations. • Maintains a professional relationship and interacts with peers, subordinates, superiors in an efficient and productive manner. • Performs other duties as assigned. Qualifications • Considerable travel during periods is required. • Must travel to all company locations and be willing to work remotely as business needs dictate. • Conversant in Billing and Eligibility procedures/regulations. • Proficient in Microsoft Word and Excel. • Excellent written and verbal communication skills. • Ability to read and interpret documents such as safety rules, operating and maintenance instructions, policies and procedure guidelines, and training manuals. • Ability to write routine reports and correspondence. • Ability to speak and present effectively before groups of customers or employees and respond to questions from groups within our organization. Company Description Delta Health Systems is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Apply tot his job Apply To this Job