-
Remote- Claims And Benefits Adjudication Auditor
3 weeks ago
Florida Health Care Plans Daytona Beach, United StatesRemote- Claims And Benefits Adjudication Auditor · Payment Integrity · Full-time · 1st shift · Monday - Friday 8am - 5pm · This position is Remote after training in our Daytona Beach office location. Remote only within our 5 county coverage area. · POSITION SUMMARY: · This ...
Claims And Benefits Adjudication Auditor - Daytona Beach, United States - Florida Health Care Plan, Inc.
Description
Claims And Benefits Adjudication AuditorPayment Integrity
Full-time
1st shift
Monday - Friday 8am - 5pm
POSITION SUMMARY:
This position is responsible for maintaining claims data quality through ongoing quality review and assessment of medical records to ensure appropriate procedures were received.
Document findings on reports and identified trends to further evaluate appropriate payment logic is built within the system as well as review post-payment claims that have been identified.
Work with the team to help document ways to improve processes for identified risks.QUALIFICATIONS:
Education, skills and experience:
Associate degree required in Business, Health Care Administration, or related field; or two (2) years of experience in revenue cycle auditing required.
Certification in CPC, RHIT or RHIA preferred.
Prior experience in testing preferred.
Strong oral, written and presentation communication skills required.
#J-18808-Ljbffr