Job Description
As a Claims Auditor, conduct pre-payment, post-payment, and claims adjudication audits across multiple employer groups and product lines. Play a key part in maintaining the integrity of claims operations by supporting all aspects of the Claims Quality Review program. Establish processing standards, respond to quality findings, assist with performance improvement plans, and provide data to support service level agreements (SLAs).
Responsibilities:
- Perform auditing of claims.
- Complete reporting of audits.
- Communicate corrections and adjustments to Examiners.
Qualifications:
- Minimum of three (3) years of experience as a claim examiner and/or auditor.
- Proficient experience in MS Word, Excel, Outlook, and PowerPoint.
- Detailed knowledge of relevant systems and proven understanding of processing principles, techniques, and guidelines.
About Centivo
Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their bills.