Claims Auditor

· 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

The requirements below represent the required knowledge, skill, and/or ability. Reasonable accommodations may be
made to enable individuals with disabilities to perform essential functions. The position requires considerable travel during periods. Candidate must travel to all company locations and be willing to work remotely as business needs dictate. Must be conversant in
Billing and Eligibility procedures/regulations and proficient in Microsoft Word and Excel. Excellent written and verbal
communication skills. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
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.

Delta Health Systems is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Salary : $25