Global Technical Talent, an Inc. 5000 Company ยท 1 day ago
Financial Compliance Auditor III, Claims
Los Angeles, CA
Contract
Hybrid
Senior Level
$50.53/hr - $55.53/hr
5+ years expGlobal Technical Talent is a not-for-profit healthcare organization focused on serving vulnerable and underserved communities in Los Angeles. The Financial Compliance Auditor III, Claims is responsible for auditing claims processed by medical groups and health plans, ensuring compliance with regulatory and contractual requirements while providing mentorship to other staff members.
CRMHuman ResourcesInformation TechnologyStaffing Agency
Responsibilities
Perform auditing procedures under minimal supervision during the audits of medical groups and health plans
Provide timely and accurate reports that detail whether medical groups and health plans are meeting certain regulatory and contractual requirements
Communicate issues and findings that would affect the audit results
Perform claims audits for all medical groups and health plans contracted with our client
Present timely audit reports to supervisor within one week of the audit date
Perform analysis of medical groups and plan partners
Set up financial audit work papers
Perform certain administrative functions for the audit team
Set up complete and timely work papers needed prior to going on-site for the claims audits
Perform other duties as assigned
Qualification
Required
Bachelor's Degree
A minimum of 5 years of experience performing claims audits or claims processing related to Medi-Cal, Cal MediConnect, and/or other managed care product lines similar to PASC-SEIU programs
Must be self-motivated
Detail-oriented
Able to prioritize assignments
Able to work as part of a team
Excellent verbal and written communication skills
Ability to interface professionally with both internal and external customers at all levels of the organization
Must also have a flexible mode of transportation for a considerable amount of travel to work off-site
Knowledge and understanding of legislation and regulatory bodies affecting healthcare practices
Knowledge of medical records systems applications
Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations, and trendsetters
Knowledge of health insurance products, market segments, and marketplaces
Preferred
Master's Degree
In lieu of a degree, equivalent education and/or experience may be considered
Benefits
Medical, Vision, and Dental Insurance Plans
401k Retirement Fund
Company
Global Technical Talent, an Inc. 5000 Company
Global Technical Talent (GTT) is a leading provider of Total Talent Solutions and a proud subsidiary of Chenega Corporation(www.chenega.com), a Native American corporation with over $1.5 billion in revenue and 7,200 U.S.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Mario Moussa
Director of Strategic Partnerships
Company data provided by crunchbase