$43,680–$49,920
USD/year
Understand and stay current with client contract criteria and requirements ensuring client services are compliant as well as meet client expectations. Ensure accuracy of claims processing and contract logic builds through internal audit processes. Perform targeted audits of claims processing including, but not limited to, high dollar payments, benefit matrix, interest payments, pre-payment and post-payment audits, and multiple procedure claims. Perform quality audits of claims staff, eligibility staff, and system logic.