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Job: Auditor - Claims Processing
Posted: 01/27/2012
Job Status: Full Time
Job Reference #: 503448
Job Description
Category: Professional
Facility: Phoenix Health Plan/Abrazo Advantage Health Plan
Department: Claims Processing
Schedule: Full Time
Shift: Day Shift
Hours: 80
Job Details:Overview: The purpose of this position is to audit all claim types in accordance with Phoenix Health Plan and Abrazo Advantage Health Plan policies and procedures to determine if the Claims Department’s quality and timeliness standards are being maintained. This individual also helps identify training needs and assists with compiling summary audit reports for internal departments and EMC. Primary duties include:
Conducts quality audits to ensure standards of accuracy and timeliness of claims payments are met and claims processing procedures are followed consistently.
Helps develop and regularly prepares summary audit reports for department management.
Identifies and communicates to department management the training needs of Claims Department staff based on audit trends.
Special Skills: Soundly familiar with managed care and have a working understanding of the operations of a claims department. Must be highly organized, professional, and have excellent written and verbal communication skills. Proficient in ICD-9, CPT, and HCPCS coding; strong numeric and analytical skills required. Proficient with claim processing systems and have the ability to use Microsoft office based applications as well as navigate proficiently on a personal computer.
Minimum Requirements: High school required. Minimum of three years prior experience as a claim analyst.
Preferred Qualifications: Three years as a claim analyst and two or more years of experience working with audit functions in a managed care or health insurance environment.
~IND
Skills / Requirements
See Above
Application Instructions
To apply directly to Phoenix Health Plan/Abrazo Advantage Health Plan, please click the link below. Another window will open and allow you to apply directly online.
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