Claims Oversight Auditor - Internal
Company: Inland Empire Health Plan
Location: Rancho Cucamonga
Posted on: May 7, 2024
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Job Description:
What you can expect!Find joy in serving others with IEHP! We
welcome you to join us in healing and inspiring the human spirit
and to pivot from a job opportunity to an authentic
experience!Under the direction of the Claims Oversight Supervisor,
the Internal Claims Oversight Auditor is responsible for ensuring
the compliance of IEHPs claims payment system and processes by
auditing claim payments using standard principles and State and
Federal regulations. The auditors are also responsible for
documenting and reporting findings and ensuring appropriate actions
have been taken to resolve payment issues with the affected
departments within IEHP, in addition to collaboration with,
inter-departments to ensure member needs are met while
simultaneously building strong peer relationships.PerksIEHP is not
only committed to healing and inspiring the human spirit of our
Members, but we also aim to match our team members with the same
energy by providing prime benefits and more.Competitive
salary.Hybrid schedule.CalPERS retirement.State of the art fitness
center on-site.Medical Insurance with Dental and Vision.Life,
short-term, and long-term disability optionsCareer advancement
opportunities and professional development.Wellness programs that
promote a healthy work-life balance.Flexible Spending Account
Health Care/ChildcareCalPERS retirement457(b) option with a
contribution matchPaid life insurance for employeesPet care
insuranceEducation & ExperienceFour (4) years auditing claims in a
managed care environment including contract and financial DOFR
interpretation.Two years (2) claims processing including Medi-Cal
and Medicare.High school diploma or GED required.Key
QualificationsYes, must have a valid California Driver's
License.Knowledge of Medi-Cal and CMS guidelines for claim
payments.Strong analytical and problem-solving skills. Must be able
to review cause and impact of problems and recommend realistic
solutions both in writing and in meetings. Microsoft Office
including being able to manipulate large data sets in Excel
files.Excellent oral and written communication skills.Start your
journey towards a thriving future with IEHP and apply TODAY!by
Jobble
Keywords: Inland Empire Health Plan, Aliso Viejo , Claims Oversight Auditor - Internal, Accounting, Auditing , Rancho Cucamonga, California
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