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9130 / Production Auditor

Position Information

Hourly Wage
• Review all monthly client adjustments
• Make sure that reference data is legible and accurate
• Learn and fully understand client systems, trending and test file processes, and the current production inventory portfolio
• Identify new trends and enhancements by comparing similar adjusted audit reasons to similar production cases
• Identify training opportunities within existing production cases
• Create and complete lead tickets and test files for client
• Review top denial reasons for training opportunities, potential rebuttals back to the client, and query enhancements
• Create action plan with summary and claim details to ensure that all reporting, training and priority recommendations are delivered to Operation Management
• Ensure that training is completed and feedback is received
• Ensure that all needed production queries are enhanced accordingly

What Project/Projects will the candidate be working on while on assignment?
• Gap analysis, identifying missed opportunity through client claim adjustment data.

Those candidates who have been successful have these traits:
• Bright
• Strong math, science, or statistics background
• A recent college graduate with a GPA of 3.7 or above, or an advanced degree
• A professional skeptic
• No less than an intermediate skill level with Excel
• Looking for an opportunity for future growth
• This is an entry level position that allows for multiple options for a career path

• Bachelor’s Degree or equivalent experience
• Experience working with medical claims platforms
• Computer proficiency in Microsoft Office including Word (create documents), Excel (data entry) and Outlook (send email / calendar utilization)
• Experience in healthcare
• Experience with medical claims (C&D and/or COB)

Posting Information

Professional Entry Level
Eligible to work WITHOUT employer visa sponsorship (i.e. U.S. Citizen/Perm. Resident)

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