Senior COB Claims Audit Lead

Molina Healthcare; United States; On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking a lead-level claims auditing professional to ensure accurate and timely implementation of critical information across claims databases. You will drive end-to-end audits, monitor backlog, and provide guidance on coverage interpretation within the audit process.

Responsibilities include creating reports, validating complex data, leading peer reviews, and mentoring team members. Ideal candidates bring 5+ years of experience and strong Excel/MS Office skills.

Qualifications

• 5+ years of claims auditing experience in health care operations.
• Expert knowledge of claims processes, auditing, and regulatory requirements.
• Experience validating provider contracting, network management and benefits.
• Strong analytical and communication skills.
• Proficiency with Excel (VLOOKUP, Pivot Tables) and MS Office.
• Preferred Bachelor’s degree.

Responsibilities

• Lead end-to-end claim audits and maintain audit records.
• Develop reporting tools and complex ad-hoc reports.
• Communicate audit findings effectively in meetings and documents.
• Mentor peers and establish best practices for audits.
• Manage projects from requirements to deployment and prioritization.

Skills

Analytical skills

Communication skills

Attention to detail

Process improvement

Flexibility

Education

Bachelor's degree

Tools

Excel

Microsoft Office

Job description

Molina Healthcare is seeking a lead-level claims auditing professional to ensure accurate and timely implementation of critical information across claims databases. You will drive end-to-end audits, monitor backlog, and provide guidance on coverage interpretation within the audit process.

Responsibilities include creating reports, validating complex data, leading peer reviews, and mentoring team members. Ideal candidates bring 5+ years of experience and strong Excel/MS Office skills.