Associate - Medical Claims Audit

Associate - Medical Claims Audit

It's more than just numbers.

Miller Kaplan is a different kind of CPA firm; we believe in building a legacyyours. We want to give our clients the very best, and we understand that begins with helping our employees be their best through professional mentorship, life-work integration, and a sense of community. That starts with you!

Job Summary

The Associate Medical Claims in the Claims Audit department is responsible for ensuring that medical claims, medical records, and other documentation essential to the healthcare industry are in compliance with federal and industry standards.

Duties / Responsibilities

• Audit medical, dental, and vision claims that have been processed by various insurance companies for multiple clients.
• Complete detailed summarized analysis audit reports within assigned budgets and deadlines.
• Conduct analysis review of claims data and reconciliation data required for preparation of claims audits.
• Process or audit claims for insurance carriers, third party administrators, or self-insured plans to ensure claims are processed in accordance with provider contracts and member benefits, compliance, and company policies and procedures.
• Research, document, and report audit error findings to clients.
• Review and analyze error trends in processing.
• Make photocopies; mail, scan, and email documents; and perform other clerical functions.
• Perform other related duties and projects as assigned.

Education and Experience

Required :

Preferred :

Required Skills / Abilities

Physical Requirements

Benefits

LIFE :

FAMILY :

BUSINESS :

DREAMS :

Ready to embark on a fulfilling career journey with us? Join our team and unlock a world of opportunities and support!

Miller Kaplan does not accept unsolicited candidates, resumes, or referrals from staffing agencies or third parties unless there is a signed agreement in place. Any submissions to any employee or owner of Miller Kaplan without a pre-existing agreement will be considered Miller Kaplan's property and not subject to fees. For existing agreements, a role must be approved by the People & Culture department in writing and open to external search; otherwise, submittals and referrals will be considered Miller Kaplan property and not subject to fees. For inquiries regarding referrals or contracts, please contact careers@millerkaplan.com.

Miller Kaplan is an equal opportunity employer and will consider all qualified applicants for employment, without regard to race, color, religion, sex, national origin, disability, or any other legally protected status in accordance with applicable federal, state, and local laws. We also consider qualified applicants with criminal histories, in compliance with federal, state, and local regulations.

Miller Kaplan is unable to sponsor applicants for employment visas now or in the future, unless otherwise specified in the job posting.

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