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Pre-Log Auditor

Company: Health Source MSO
Location: Alhambra
Posted on: May 27, 2023

Job Description:

Pre-Log Auditor will be responsible for auditing and loading health insurance 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:

Load electronic files to the claims system
Manually create claims in the claims system
Analyze documentation to determine proper eligibility
Audit accuracy of 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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