Auditor - Provider Recovery - Rancho Cucamonga, United States - Inland Empire Health Plan

Inland Empire Health Plan
Inland Empire Health Plan
Verified Company
Rancho Cucamonga, United States

2 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

What you can expect
Find joy in serving others with IEHP We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an
authentic experience


Under the direction of the Provider Claims Resolution & Recovery Supervisor, the Provider Recovery Auditor is responsible for the audit and recovery of claims overpayments including COB and third-party liability.


Commitment to Quality:

The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.


Perks


IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.


  • CalPERS retirement
  • 457(b) option with a contribution match
  • Generous paid time off
- vacation, holidays, sick

  • State of the art fitness center onsite
  • Medical Insurance with Dental and Vision
  • Paid life insurance for employees with additional options
  • Shortterm, and longterm disability options
  • Pet care insurance


  • Flexible Spending Account

  • Health Care/Childcare
  • Wellness programs that promote a healthy worklife balance
  • Career advancement opportunities and professional development
  • Competitive salary with annual merit increase
  • Team bonus opportunities

Education & Experience

  • Four (4) years claims processing experience including Medicare and Medi-Cal
  • Two (2) years of experience auditing claims in a managed care environment including contract and financial DOFR interpretation

Key Qualifications

  • Strong analytical and problemsolving skills
  • Must be able to review cause and impact of problems and recommend realistic solutions both in writing and in meetings
  • Microsoft Office including being able to manipulate large data sets in Excel files
  • Excellent oral and written communication skills
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