Claims Auditor: Medical Claims Analysis & Reporting

Southwest Service Administrators Inc; Phoenix (AZ); On-site; USD 52,000 - 80,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Short-term Disability

401K Plan (company match)

Pension Plan

Paid Time Off

Job summary

Southwest Service Administrators Inc. seeks a Claims Auditor to oversee audit activities for medical and dental claims, supporting the team manager and generating statistical audit reports and documentation.

Responsibilities include auditing and reporting, applying plan designs, staying current with policies and compliance, researching claim issues, preparing management summaries, and assisting in system testing during upgrades. Strong attention to detail is essential.

Qualifications

• Must analyze medical claims and extract conclusions with accuracy.
• Strong attention to detail and ability to meet deadlines.
• Excellent written and oral communication for reporting observations.

Responsibilities

• Auditing and reporting on medical/dental claims.
• Maintain understanding of plan designs, policies, and compliance regulations.
• Prepare management reports and summaries of observations and recommendations.

Skills

Medical claims analysis

Attention to detail

Communication skills

Independent work

Education

High School Diploma/GED

Tools

MS Excel

MS Word

Job description

Southwest Service Administrators Inc. seeks a Claims Auditor to oversee audit activities for medical and dental claims, supporting the team manager and generating statistical audit reports and documentation.

Responsibilities include auditing and reporting, applying plan designs, staying current with policies and compliance, researching claim issues, preparing management summaries, and assisting in system testing during upgrades. Strong attention to detail is essential.