A US-based insurance company is seeking a meticulous Claim Auditor to conduct daily pre-claim submission reviews of Medicaid trip claims. Responsibilities include reviewing and auditing spreadsheets, ensuring accuracy, and validating claims against compliance standards. The ideal candidate demonstrates strong attention to detail and proficiency in spreadsheets, alongside excellent organizational skills. This role requires self-motivation and the ability to work independently in a remote environment.
Qualifications
Familiarity with regulatory or documentation guidelines relevant to the industry is a plus but not required.
Strong attention to detail with a high level of accuracy in data handling.
Proficient in using spreadsheets (Google Sheets or Microsoft Excel) for data input and tracking.
Excellent organizational and time management skills to meet deadlines.
Self-motivated and able to work independently in a remote setup.
Responsibilities
Review and audit Medicaid Trip Spreadsheet and associated forms.
Ensure required fields are complete and accurate, including Member ID, driver and vehicle information, pickup/drop-off details, and signatures.
Validate claims against audit standards and regulatory requirements set forth by the Colorado Department.
Track and report claim status changes, including reclassified denied claims.
Prepare monthly audit reports detailing total claims reviewed, status breakdown, and resolution of outstanding denied claims.
Ensure turnaround times for daily claim audits are met.
Skills
Attention to detail
Data handling accuracy
Proficient in spreadsheets
Organizational skills
Time management
Self-motivated
Job description
A US-based insurance company is seeking a meticulous Claim Auditor to conduct daily pre-claim submission reviews of Medicaid trip claims. Responsibilities include reviewing and auditing spreadsheets, ensuring accuracy, and validating claims against compliance standards. The ideal candidate demonstrates strong attention to detail and proficiency in spreadsheets, alongside excellent organizational skills. This role requires self-motivation and the ability to work independently in a remote environment.