Claims Auditor

Job Description: Claims Auditor will be responsible for auditing claims processed by Claims Examiners. Responsibilities include, but not limited to: Maintain up-to-date knowledge of procedures for all ICD-10, CPT, HCPC codes including: Contractual agreement rates Health Plan procedures Medicare and Medi-cal reimbursement Claims processing guidelines Evaluate claims based on DMHC and DHS regulations Respond and resolve providers’ and health plans’ inquires in a timely manner Check for adjudicati…