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WelbeHealth

WelbeHealth is a healthcare company that is on a mission to help elderly adults continue to live independently in their own homes and communities. The company is known for its fast

Claims Audit Analyst

Location

California

Posted

18 days ago

Salary

$67.8K - $89.5K / year

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

Claims Audit Analyst

WelbeHealth

• Review processed claims for accuracy prior to payment while maintaining acceptable levels of claim’s aged inventory by verifying various aspects of the system and claim • Complete and maintain detailed documentation of audit findings which include decision methodology, system or processing errors, and monetary discrepancies • Move claims free of processing errors through for full adjudication and return claims with errors back to the claims team for corrections • Provide feedback to the Oversight & Monitoring Manager on claims processing errors, quality improvement opportunities, and configuration change requests, when applicable

Job Requirements

  • Minimum of three (3) years of experience processing and auditing Medicare and Medicaid professional, institutional, and dental health insurance claims
  • Working knowledge of the health plan insurance industry, CPT/HCPCS procedure codes, ICD-10 codes, and relevant federal and state regulations
  • Experience working with CMS and Medicaid healthcare claims highly preferred
  • Demonstrated skills within Microsoft Office Applications, including Excel

Benefits

  • Medical insurance coverage (Medical, Dental, Vision)
  • Work/life balance – we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, sick time
  • Advancement opportunities - We’ve got a track record of hiring and promoting from within, meaning you can create your own path!
  • And additional benefits

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