Claims Auditor

Job Details Job Location: DHS Remote - Stockton, CA Position Type: Full Time Salary Range: $22.00 - $26.00 hourly Job Category: QA - Quality Control, Audits, Claims, Customer Service and OA personnel by performing the following duties. Responsibilities: - Audits work of self-funded Claims and Customer Service department for accuracy according to established procedure guidelines. - Reviews and identifies technical and system quality issues for all aspects of claim processing, corr/recon, and customer service. - Documents, maintains and reports audit statistics - Accurately interprets claim policy, procedures and standard group benefit provisions - Provides feedback to management and reviewed employees regarding quality of work - Maintains confidentiality of employee audits - Adheres to company rules and regulations - Maintains a professional relationship and interacts with peers, subordinates, superiors in an efficient and productive manner - Performs other duties as assigned Qualifications: - EDUCATION/EXPERIENCE: One year certificate from college or technical school; or one to three years related experience; and/or equivalent combination of education/experience. - QUALIFICATIONS: Successful candidate will have medical, dental and hospital claims processing experience; a strong understanding of computerized claims payment systems, preferably at Delta Health Systems; excellent organizational skills; a thorough understanding of technical claims issues and system edits; working knowledge of Microsoft Word and Excel; and exceptional analytical skills.