Claims Auditor

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $29 - $45 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Providence

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1856

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

Providence is a not-for-profit health system committed to providing a wide range of medical services, including primary care, urgent care, pediatrics, maternity care, cancer treatment, and specialized services like neurosurgery and orthopedics. They offer both in-person and virtual care through clinics and a mobile app, ensuring patients can access healthcare conveniently. With a mission rooted in compassion, dignity, and justice, Providence emphasizes serving those who are vulnerable and strives for excellence in healthcare delivery. They are involved in research and innovation, including genomic profiling and clinical trials to improve patient outcomes.

📋 Description

• Maintain managed care health plan delegated auditing functions • Review pre-payment and post-payment claims • Document assigned errors • Report claims processing errors • Provide feedback to ensure compliance with health plans and regulatory agencies • Conduct routine and complex audits to identify exceptions to claims adjudication requirements • Secure data integrity and maintain accuracy standards for claims processing, payment, and procedural accuracy • Report to the Supervisor, Claims Audit

🎯 Requirements

• 3 years of claims processing experience in a managed care environment • 1 year of claims audit experience (preferred) • Experience processing Medicare, Medi-Cal, or One Care Connect claims (preferred) • Knowledge of CMS, DMHC, and DHCS regulatory requirements

🏖️ Benefits

• Retirement 401(k) Savings Plan with employer matching • Medical, dental, and vision health care benefits • Life insurance • Disability insurance • Paid parental leave • Vacation and holiday time off • Health-related time off benefits • Voluntary benefits • Well-being resources • Inclusive workplace and equal opportunities for advancement