Do you have experience in the following?
- Insurance Claims processing
- Medical Billing and/or Coding
Does the following interest you?
- A fast paced, casual work environment
- Research and investigation of medical claims
- Auditing medical claims for accuracy
If you answered yes to any of the above, West’s Accent Cost Containment division has an opportunity to join their team as an Insurance Claims Validator (Medical Claims Auditor) in our Omaha, NE location!
With this opportunity, you will gain valuable insurance claims experience through auditing medical claims to discover discrepancies related to insurance overpayments. You will research and investigate insurance claims in various systems, as well as audit claims for accuracy and eligibility. Once the claim is determined to be legitimate, records are updated accordingly. If fund recovery opportunities are identified, the claim record(s) are then sent to our fund’s recovery team for additional follow-up on behalf of the largest healthcare providers in the world.
Other responsibilities of the Insurance Claims Validator role include:
- Identify and define claims errors and discrepancies
- Review and analyze provider contracts and health plan reimbursement regulations
- Update and develop new and current audit reports and develop and run custom queries
- Working with a variety of claims including Medicare, Facility, In-patient, and Out-patient
- Develop and implement new ideas that will help better recognize incorrect payments and generate a higher quality of recoverable claims
- Meet or exceed department attendance and quality goals