Medical Claims Auditor
hace 1 mes
At Experian, we strive to simplify healthcare using data-driven insights. Our culture values openness, innovation, and accountability, making it an ideal place for a Medical Claims Auditor.
The role involves monitoring contractual allowances, analyzing appeal opportunities with payers and networks, and reporting appeals performance. Key responsibilities include:
- Identifying under-allowed claims using software and other tools.
- Reviewing EOBs for identified under-allowed claims.
- Verifying applicable contracts through operational procedures.
- Refining communication skills to prepare written and telephone appeals.
- Compiling and submitting appeals, and monitoring for proper reimbursement.
- Establishing helpful contacts in payer or network offices.
- Preparing monthly performance statistics.
- Maintaining confidentiality and providing continuous feedback.
To excel in this role, you will require:
- A high school diploma with some university studies preferred.
- 1-2 years' experience working with managed care claims and appeals.
- Proficiency in Microsoft Office products, including Excel.
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{"text":"Invoice Claims Specialist
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