Senior Compliance Claims Auditor, Claims

What you'll do :

• Audit medical claims received from providers for adjudication accuracy. This includes both professional and institutional claims of all types.
• Manage internal and external audits.
• Provide timely input on compliance-related issues and guidance requests
• Assist with compliance risk assessments and audit readiness
• Assist with new compliance regulation implementation related to claims accuracy.
• Collaborate with team members to identify and mitigate compliance risk for claims.
• Work closely with Collective Health attorneys to receive and coordinate legal guidance needed to operationalize important initiatives and requirements

To be successful in this role, you'll need :

At least 5 years of experience auditing medical claims

Pay Transparency Statement

This job can be performed in a location where we have an office : San Francisco, CA, Lehi, UT, or Plano, TX, with the expectation of being in office at least two weekdays per week, or hired for remote work in the following states : AZ, CA, CO, CT, FL, GA, IL, MD, MA, MI, MN, NV, NJ, NY, NC, OH, OR, TN, TX, UT, VA, WA, or WI.

The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the salary, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off.