Claims Auditor; Remote - WI or MN

Employer Industry: Healthcare Services

• Opportunity for career advancement and growth within the organization
• Work remotely from Wisconsin or Minnesota
• Supportive and collaborative work environment
• Chance to make a positive impact on patient care through quality auditing
• Regular full-time position with a structured schedule (Mon-Fri, day shifts)

• Perform payment, procedural accuracy, turnaround time, compliance, and operational audits as directed by management
• Apply effective audit procedures in collecting, analyzing, and reporting findings
• Ensure adherence to regulatory standards and internal policies in claim processing
• Collaborate with team members to resolve issues related to claims
• Maintain up-to-date knowledge of coding standards and healthcare regulations

• High school diploma or equivalent
• Minimum of three years’ experience in health insurance claim processing
• Three years’ experience related to CPT/HCPCS and current ICD coding
• Proficiency with analytical problem-solving, written and oral communications, and the Microsoft Office Suite
• Certified Professional Coder (CPC) or Certified Professional Coder – Payer (CPC-P) certification awarded by the American Academy of Professional Coders (AAPC) within three years of hire

• Associate degree in business, medical, or a related field
• One year of experience in claims auditing
• Certified Professional Coder (CPC) or Certified Professional Coder – Payer (CPC-P) certification at the time of hire

#Healthcare Services #Claims Auditor #Remote Work #Career Opportunity #Healthcare Compliance

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