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Claims Auditor Ii Jobs in Ohio

Claims Qa Auditor - Claims - Paramount
By ProMedica At , Toledo, 43606, Oh
Experience or strong working knowledge of benefit/pricing configuration, provider database maintenance, or related configuration experience desired.
Associates degree in Finance/auditing strongly preferred
Spreadsheet and database skills required. Demonstrated Excel at least level 2
Excellent written, verbal, and interpersonal communication skills required
Quality assurance program experience highly desirable
Good working knowledge of HCFA, State of Ohio and Michigan compliance regulations, and institutional/professional ECS submission formats highly desirable.
Quality Control Auditor Ii
By Lennar Homes At , Miami, 33126, Fl $36 an hour
Minimum of six years’ experience in mortgage lending
Minimum of three years underwriting experience or equivalent with Conventional, FHA and VA loan products preferred
Previous experience with loan closings and regulatory compliance
Experience in ACES, BlitzDocs & Destiny preferred
This position will be eligible for the benefits listed above in accordance with Company policy.
Become a subject matter expert in certain aspects of loan origination, such as regulatory compliance or credit underwriting
Claims Representative Ii - Remote
By Ryder System At , Frankfort, 40621, Ky $48,300 - $72,450 a year
Interacts, on an on-going basis, with field and operations management, legal counsel, safety managers, customers, insurance carriers, and third party claimants
data/ranges; applicant’s skills; prior relevant experience; certain degrees or
Ryder offers comprehensive health and welfare benefits, to include medical,
Manages litigation to ensure claims are handled appropriately, according to the applicable jurisdiction
Assists Claim Manager in the identification of exposures and recommends solutions
Manages indemnity and expense costs properly
Quality Associate Ii (Auditor)
By BAXTER At , Jayuya, Pr
Identifies possible Regulatory Risks within the Baxter Jayuya operations and notified to management.
Perform and support Quality Management System activities required or assigned to assure the facility compliance.
Coordinate, manage and follow up the Internal Audit program.
Support and perform the plant annual FDA 483’s Certification.
Performs changes to procedures for areas of responsibilities.
Manage and use the applicable software application (Trackwise).

Are you looking for an exciting opportunity to use your auditing skills to help protect the financial interests of a company? If so, then we have the perfect job for you! We are looking for a Claims Auditor II to join our team and help us ensure that all claims are accurate and compliant with regulations. You will be responsible for reviewing and analyzing claims data, identifying discrepancies, and making recommendations for corrective action. If you are detail-oriented, have excellent problem-solving skills, and are passionate about protecting the financial interests of a company, then this is the job for you!

Overview:

Claims Auditor II is responsible for auditing and verifying insurance claims to ensure accuracy and compliance with applicable laws and regulations. They review claims for accuracy and completeness, investigate discrepancies, and recommend corrective action. They also provide guidance and advice to claims adjusters and other staff on claims processing and related matters.

Detailed Job Description:

Claims Auditor II is responsible for auditing and verifying insurance claims to ensure accuracy and compliance with applicable laws and regulations. They review claims for accuracy and completeness, investigate discrepancies, and recommend corrective action. They also provide guidance and advice to claims adjusters and other staff on claims processing and related matters. They may also be responsible for preparing reports, analyzing data, and making recommendations for improvement.

What is Claims Auditor Ii Job Skills Required?

• Knowledge of insurance claims processing and related regulations
• Excellent analytical and problem-solving skills
• Ability to work independently and as part of a team
• Excellent communication and interpersonal skills
• Proficiency in Microsoft Office Suite
• Ability to work with large amounts of data
• Ability to work under pressure and meet deadlines

What is Claims Auditor Ii Job Qualifications?

• Bachelor’s degree in accounting, finance, or related field
• At least two years of experience in insurance claims auditing
• Certified Public Accountant (CPA) or Certified Internal Auditor (CIA) certification preferred

What is Claims Auditor Ii Job Knowledge?

• Knowledge of insurance claims processing and related regulations
• Knowledge of auditing principles and practices
• Knowledge of accounting principles and practices

What is Claims Auditor Ii Job Experience?

• At least two years of experience in insurance claims auditing

What is Claims Auditor Ii Job Responsibilities?

• Review and audit insurance claims for accuracy and completeness
• Investigate discrepancies and recommend corrective action
• Provide guidance and advice to claims adjusters and other staff on claims processing and related matters
• Prepare reports, analyze data, and make recommendations for improvement
• Monitor claims processing activities to ensure compliance with applicable laws and regulations
• Maintain accurate records and documentation of audit findings and recommendations