Job Description:

Job Description: Clinical Auditor (Insurance Division)

Responsibilities:

• Review and analyze medical records to ensure compliance with insurance policies and guidelines
• Identify and report any discrepancies or fraudulent activities
• Conduct audits of medical claims to verify accuracy and adherence to regulations
• Monitor and track audit findings and communicate results to relevant stakeholders
• Develop and implement strategies to improve audit processes and increase efficiency

Skill Sets:

• Strong understanding of medical billing and coding practices
• Knowledge of insurance regulations and compliance requirements
• Excellent analytical and problem-solving skills
• Attention to detail and accuracy in reviewing documents
• Effective communication and interpersonal skills
• Ability to work independently and as part of a team
• Proficiency in data analysis and reporting tools

Industry:

Insurance

Category:

Insurance Brokerage

Skills: