Job Abstract

Take on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health. The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract interpre... more details

General Information

Work Location: Los Angeles, USA

Onsite or Remote

Flexible Hybrid

Work Schedule

Monday - Friday, 7:00am - 3:30pm PST

Posted Date

03/19/2024

Salary Range: $24.28 - 48.04 Hourly

Employment Type

2 - Staff: Career

Duration

indefinite

Job #

9046

Primary Duties and Responsibilities

The Claims Quality Auditor will be responsible for the daily audit of all examiners assigned to the auditor. You will review claims (paid, pending, and denied) for accuracy, appropriate application of benefits, authorization for services, contract interpretation, Division of Financial Responsibility (DOFR), and application/compliance with policies and procedures. You will:

Research over and under-payment inquiries/appeals
Compile and maintain statistical data consistent
Maintain departmental production and quality standards

Note: This posted position is 1 of 2 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions.

Salary Range: $24.28 - $48.04 Hourly

Job Qualifications

We’re seeking a self-motivated, detail-oriented, deadline-driven individual with:

High school diploma, GED or equivalent
Minimum five years of medical claims payment experience in an HMO environment
Experience with CPT-4, ICD-9CM, RBRVS, ASA, and HCPCS
Understanding of Medicare Guidelines and COB
Knowledge of medical terminology
Experience in benefit determination and claims adjudication
Ability to accurately key 6,000-8,000 keystrokes or type 40-50 WPM
Understanding of professional and facility reimbursement methodologies
Strong organizational skills
Computer proficiency with Microsoft Office
Knowledge of claims adjudication systems
Flexibility and adaptability

UCLA Health is a world-renowned health system with four award-winning hospitals and more than 250 community clinics throughout Southern California. We are also home to the David Geffen School of Medicine, a highly respected leader in the development of breakthrough medical research and outstanding clinical professionals. If you’re looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.

Search Terms: Auditor, Claims, Quality, Audit, Health

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Jobs: $15-$57/Hr. Multiple Positions Hiring Immediately

Los Angeles

Hiring Immediately! Multiple Positions Available. $15-$57/Hr.