Medical Claims Auditor - Lincolnwood Illinois

Company: VirtualVocations
Location: Lincolnwood, Illinois
Posted On: 11/15/2024

A company is looking for a Medical Claims Auditor to audit and adjudicate stop loss insurance medical claims.



Key Responsibilities

Review and audit medical stop loss claim submissions against relevant documents and standards
Compile periodic reporting for internal and external parties, and advise on claim projections
Recognize and document trends in claims, providing ongoing feedback for quality improvement


Required Qualifications and Education

High School Diploma or GED required; Bachelor's degree in Medical Billing and Coding or related field preferred
5+ years of experience in medical claims administration; understanding of Third Party Administration functions preferred
Knowledge of medical terminology required
Working knowledge of Microsoft Office products
Experience with self-quality monitoring and executing plans to meet established goals More...

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