Our Client, a Health Insurance company, is looking for a Healthcare Claims Auditor II for their Detroit, MI location. Responsibilities:


+ Support audit coordination for group customer accounts requesting claims accuracy reviews.

+ Responsibilities include managing inbound audit requests, coordinating documentation and issue tracking.

+ Will facilitate communication between customers and operational teams.

Requirements:

+ The ideal candidate is detail-oriented, comfortable navigating complex claims data and experienced in medical claims.

+ Familiarity with medical claims or benefits (MA or Commercial)

+ Knowledge of CMS rules and regulations

+ Strong Project Management

+ Knowledge of medical claims or benefits (MA or Commercial)

+ Strong Communication Skills

+ Project management Skills

+ Knowledge of IKA or NASCO claims processing systems

+ Exper...