Medical Auditor II

Role Overview

• Review automated audit results and documentation and make adjustments to audit results when necessary.
• Forward audit recommendation to claims adjuster for final review and payment determination.
• Research medical audit and system issues and communicate this information with recommended actions.
• Explain pertinent laws, rules, and policies to internal and external customers.

Requirements

• Three or more years of experience processing medical insurance billings and using medical terminology, ICD-10 and CPT codes.
• High school graduation or equivalent education and completion of medical terminology and ICD-10/CPT code courses.
• Other combinations of skills and experience may be considered.

Benefits

• Health care
• Retirement savings plans
• Paid time off