Claims Quality Auditor

UCLA Outpatient Clinics; Los Angeles (CA); On-site; USD 43,408 - 86,292; Full time

Job summary

UCLA Outpatient Clinics is seeking a Claims Quality Auditor to ensure the accuracy of claims processing at a world-class health organization. You will be responsible for auditing claims, including researching payment inquiries and maintaining quality standards.

The ideal candidate will possess strong attention to detail and have experience interpreting healthcare policies. The salary range for this position is $31.51 to $62.64 per hour.

Qualifications

• Strong attention to detail for accurate claims review.
• Ability to interpret and apply healthcare policies and procedures.
• Experience with statistical data compilation.

Responsibilities

• Conduct daily audits of claims for accuracy.
• Research payment inquiries and appeals.
• Maintain quality and production standards.

Job description

Description

Take on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health.

The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract interpretation, Division of Financial Responsibility (DOFR), and application/compliance with policies and procedures. You will:

• Research over and under-payment inquiries/appeals
• Compile and maintain statistical data consistent
• Maintain departmental production and quality standards

Salary Range: $31.51 - $62.64 Hourly