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POSITION SUMMARY:
These duties are split over four Auditor positions. Claims Auditors are responsible for the auditing of provider disputes, member denial letter requests, and daily prelag reports. Responsible for ensuring provider dispute and member denial letters are accurately handled. Responsible for notifying management of any compliance concerns with timeliness of claims payments. Reviewing and resolving HPIs and member OOP.
This position is primary focus on reviewing member out of pocket max notices and process corrections to member OOP as needed. Reviewing & processing member copay corrections. Position will also focus on check run reviews, including working all pre/post check run audit reports to ensure claims payments are accurate.
JOB DUTIES:
POSITION QUALIFICATIONS AND REQUIREMENTS
Experience/Specialized Skills:
Education/Course(s)/Training: High School Diploma required.
Licensure/Certification: N/A
Work Schedule:
View our company website to learn more about the company and career opportunities. You may apply through the company website or through Indeed.
www.scpmcs.org
SCPMCS is an Equal Opportunity Employer
Job Type: Full-time
Pay: $21.66 - $26.53 per hour
Benefits:
Application Question(s):
Education:
Experience:
Location:
Work Location: Remote
Full Time
$63k-79k (estimate)
05/10/2024
09/06/2024