Auditor I

Department: SHS MA Group Medicare S

Will this position be required to work onsite for any reason at any time? No

Engagement Description – Support audit coordination for group customer accounts requesting claims accuracy reviews. Responsibilities include managing inbound audit requests, coordinating documentation and issue tracking. Will facilitate communication between customers and operational teams. The ideal candidate is detail-oriented, comfortable navigating complex claims data and experienced in medical claims.

Top 3 Required Skills/Experience –
• Familiarity with medical claims or benefits (MA or Commercial)
• Knowledge of CMS rules and regulations
• Strong Project Management

Required Skills/Experience – The rest of the required skills/experience. Include:
• Knowledge of medical claims or benefits (MA or Commercial)
• Strong Communication Skills
• Project management Skills

Preferred Skills/Experience – Optional but preferred skills/experience. Include:
• Knowledge of IKA or NASCO claims processing systems
• Experience with Data Validation

Education/Certifications – Include:
• Bachelor's degree in Business Administration, Healthcare administration, Accounting, Finance or related field preferred.