Claims Auditor

Job not on LinkedIn

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $24 - $28 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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MedPOINT Management

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1988

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

MedPOINT Management is a California-based healthcare management services organization that supports independent practice associations (IPAs), provider networks, hospitals and contracted health plans with clinical quality, care management, administrative operations and technology solutions. For more than 32 years MPM has provided services including provider network operations, case management, utilization management, claims operations, credentialing, HEDIS/STARs quality measurement and analytics (via Cozeva), call center and financial management, and digital provider portals and resource libraries. The company emphasizes data security and compliance (SOC 2 and HITRUST e1 certifications for its EZ-CAP and Provider Web Portals) and focuses on enabling value-based care, quality improvement, and operational support for providers and payers.

📋 Description

• Audit medical claims for accuracy, completeness, and compliance with payer guidelines and contractual agreements • Review and analyze claims data to identify billing errors, overpayments, and underpayments • Conduct pre- and post-payment audits to ensure proper reimbursement and reduce financial risk • Document audit findings and prepare detailed reports for management review • Collaborate with claims processing and provider relations teams to resolve discrepancies • Monitor claims trends and recommend process improvements to enhance accuracy and efficiency • Ensure compliance with federal, state, and managed care regulations, including ICD-10, CPT, and HCPCS coding standards

🎯 Requirements

• 2+ years of experience in claims auditing, claims processing, or healthcare billing • Strong knowledge of ICD-10, CPT, and HCPCS coding • Familiarity with managed care, IPA, or HMO claims environments preferred • Proficiency in claims management systems and Microsoft Office Suite • Exceptional attention to detail and strong analytical skills • Excellent written and verbal communication skills for reporting and cross-team collaboration • CPC, CCA, or related coding/billing certification is a plus

🏖️ Benefits

• 401(k) • 401(k) matching • Company parties • Dental insurance • Employee discounts • Health insurance • Opportunity for advancement • Paid time off • Parental leave • Savings bank • Training & development • Vision insurance • Wellness resources • Collaborative work culture • Professional growth opportunities