Claims Auditor Claims Auditor …

The Jacobson Group
in Chicago, IL, United States
Temporary, Full time
Be the first to apply
Competitive
The Jacobson Group
in Chicago, IL, United States
Temporary, Full time
Be the first to apply
Competitive
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Posted by:
Posted by:
Assistant Research Manager
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Medicare and Medicaid Claims Analyst Needed

Requirements:

  • Minimum 3+ years of recent claims auditing
  • Medicaid and Medicare
  • Experience pulling, reviewing and using Fee Schedules
  • Experience reading and reviewing provider contracts for auditing

Preferred:

  • Previous experience as a: Post Payment Auditor, Claims Auditor, Pre Payment Auditor
  • Amysis Experience

Responsibilities: 

The auditor will uncover issues with the way the system is linking the providers fee schedules. The auditor would look at the claims for any alterations (i.e. Modifiers billed but not keyed, denials applied to the claim in error resulting in an underpayment, incorrect data entry not corrected before finalizing resulting in overpayments etc.) This position is not looking at coding or editing. Just reading and applying the policy against the examiners action that altered the payment and whether it was supported by the policy and whether the fee schedule on the provider file is interfacing accurately with the claim.

 

Jacobson has helped more than 10,000 insurance professionals to reach their career objectives since we opened our doors in 1971. Whether they are looking to advance their careers through a job change or temporary opportunity or want to serve the industry as insurance consultants, Jacobson is the trusted career resource for insurance professionals.

We are in the business of creating meaningful client and candidate matches that yield success for both parties. All of our insurance placement services are free of charge to candidates, and assignments are handled with the highest degree of confidentiality.

 

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