Aerospace QMS Auditor
KBR, Inc.
Claims Quality Auditor
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Remote • Florida • 🇺🇸 United States
Visit company websiteSalary
💰 $19 - $32 per hour
Job Level
JuniorMid-Level
About the role
- Independently perform comprehensive audits of claims to source documents and identify incorrect payments
- Conduct quality audits of claims, pre and post payments
- Analyze errors and determine root causes for appropriate classification
- Utilize audit software to provide written documentation regarding audit observations
- Analyze and review responses to audit observations
- Facilitate corrective action plans
- Monitor state websites and contract changes for impact on claim payments
Requirements
- Associate’s degree in related field or equivalent experience
- 2+ years of medical or pharmacy claims processing, training or auditing experience
- Knowledge of claim software systems
- Microsoft Office applications
- Medicaid and Medicare reimbursement rules
- Ability to interpret state and provider contracts
- Knowledge of CPT/HCPCS Coding preferred
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims auditingerror analysisroot cause analysisCPT codingHCPCS codingclaims processingaudit documentationcorrective action plansquality auditscontract interpretation
Soft skills
independent workanalytical skillsattention to detailcommunication skillsproblem-solving
Certifications
Associate’s degree
