Qureos Mentor

Hoag Health System

Hoag is a nonprofit, regional health care delivery system in Orange County, California, providing world-class, comprehensive, personalized care. With a network of 1,800 top physicians, 17 urgent care facilities, 12 health and wellness centers, and two award-winning hospitals, Hoag offers a wide range of health care services. This includes specialized institutes focusing on cancer, digestive health, heart and vascular care, neurosciences, spine, women’s health, and orthopedics. Hoag is recognized as the highest ranked hospital in Orange County by U.S. News & World Report.

<div>Primary Duties and Responsibilities
The Claims Auditor is responsible for performing pre-payment and post-payment audits ensuring financial and processing accuracy, compliance with regulatory and health plan requirements of claims processed.
The Claims Auditor is responsible for auditing and confirming accuracy of the loading of:
<ul><li>Fee schedules
</li><li>Provider contracts
</li><li>Payor contracts
</li><li>Benefits
</li><li>Code changes
</li><li>System enhancements</li></ul></div>
 <div>Education and Experience
<ul><li>High School Diploma or equivalent
</li><li>5 years of experience in a medical claims processing environment
</li><li>Knowledge of HMO/managed care regulatory guidelines
</li></ul>Preferred:
<ul><li>Experience with Epic Tapestry system
</li><li>3 years experience in claim audits, revenue recovery, or claims system configuration
</li></ul>License Required
N/A
License Preferred
N/A
Certifications Required
N/A
Certifications Preferred
N/A</div>

Claims Auditor: Hoag Clinic Claims & Enrollment

Join Hoag Health System and explore 1   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Hoag Health System

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Claims Auditor: Hoag Clinic Claims & Enrollment