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Pre-Log Auditor

Company: Health Source MSO
Location: Alhambra
Posted on: November 12, 2021

Job Description:

Employer: Health Source MSO Job Title: Pre-Log Auditor # of Openings: 2 Days: Mon --- Fri, 8:30am --- 5pm Wage/Salary: DOE Job Description: Pre-Log Auditor will be responsible for auditing in-load claims with efficiency and accuracy. Audit all paid and denied claims to identify processing errors and coordinate with management to develop processing standards as well as implement procedures for internal auditing process. Responsibilities include, but not limited to: Analyze documentation to determine proper eligibility Audit accuracy of in-loaded claims Develop and run claims processing reports to assist in periodic monthly audit reporting Assist in recoveries of overpaid claims Respond and resolve providers--- and health plans--- inquires in a timely manner Participate in communicating with management regarding claim audit results Observe and evaluate employee claims processing techniques to provide feedback and standardize guideline Maintain quality and productivity standards Participate in special projects Work closely with Supervisor and report any issues Qualifications: AA degree with related experience. Bachelor---s preferred. Must have good written and communication skills. Must be able to follow guidelines, multi-task, and work comfortably within a team-oriented environment. Must have a high level attention to details Computer literacy required, including proficient use of Microsoft Word, Excel, Outlook, and EZ-CAP. Typing skills of at least 40 wpm.

Keywords: Health Source MSO, Alhambra , Pre-Log Auditor, Accounting, Auditing , Alhambra, California

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