Healthcare Claims Auditor I

Our Client, a Health Insurance company, is looking for a Healthcare Claims Auditor II for their Detroit, MI location.
 
Responsibilities:

• 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.
• Familiarity with medical claims or benefits (MA or Commercial)
• Knowledge of CMS rules and regulations
• Strong Project Management
• Knowledge of medical claims or benefits (MA or Commercial)
• Strong Communication Skills
• Project management Skills
• Knowledge of IKA or NASCO claims processing systems
• Experience with Data Validation
• Bachelor's degree in Business Administration, Healthcare administration, Accounting, Finance or related field preferred.

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities