Auditor, Delegate Claims

🔥 36 minutes ago

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Alignment Health

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

💰 $135M Series C on 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

📋 Description

• Conduct audits in accordance with regulatory, contractual, and industry standards • Validate Corrective Actions are effective • Report audit findings to facilitate organizational awareness • Manage multiple audits and related projects simultaneously

🎯 Requirements

• 3-5 years of claims experience in an HMO, Medicare Advantage, and/or IPA setting • 1-2 years minimum experience conducting oversight audits of delegated entities and/or ancillary providers • Strong knowledge of Medicare audit processes • Exceptional organizational skills • Excellent verbal and written communication skills

🏖️ Benefits

• Health insurance • 401(k) matching • Paid time off • Professional development opportunities

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