Description

With general supervision, verify claims processing, system accuracy, and data entry accuracy, identify and communicate errors, and track errors for trends.

Essential Functions

Perform scheduled quality assurance audits for both In-Network and Out-of-Network claims

Record and track audit errors; identify trends and opportunities to improve quality

Provide feedback from errors and submit quality assurance audit reports

Perform pro-active system audits to ensure that the Claims processing systems are editing and pricing claims correctly

Act as a key contact to business partners to provide information in regard to complex claim errors and processing procedures

Requirements

Job Specifications 

Typically has the following skills or abilities: 

Two to four years of claims processing experience handling complex claims in a high-volume environment or similar experience

One year of claims processing experience within our company preferred

Thorough understanding of Claim Services processing procedures and the CLS Document Library

Proven ability to prioritize work and multi-task

Familiar with Claims reporting tools, Word, and Excel

Excellent oral and written communication skills

#LI-ONSITE

The compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding iCare benefits, please click here.