Implementation Auditor (50487)

The physical demands and work environment described here are representative of those that must be met by an employee to perform the essential functions of this job successfully.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to communicate with others.

The employee frequently is required to move around the office.

The employee is often required to use tools, objects, and controls.

This noise level in the work environment is usually moderate.

• BS/BA degree in Business or related field and a minimum of three (3) to (5) five years of recent experience as a medical/dental claims auditor or plan testing experience, preferred.
• Exceptional understanding and ability to interpret summary plan descriptions of employee medical/dental benefits.
• Strong ability to work efficiently and effectively in a multiple task, multi-project, and multi-demanding

environment to meet expected goals, dates, and milestones.

• Ability to anticipate problems, recommend solutions, and exercise best judgement.
• Excellent writing, editing, and proofreading skills to compose and edit correspondence, reports, emails, and other written materials.
• Proficient ability to analyze and interpret group health benefits provisions, administrative policies, and provider contracts.
• Previous experience with conducting research and presenting complex information.
• Excellent communication and interpersonal skills.
• Superior organization skills and high attention to detail.
• Ability to learn complex business processes and appropriately apply knowledge to make informed decisions.
• Advanced skills in Microsoft Office applications.
• Knowledge of medical terminology. Familiar with ICD10, CPT, HCPC, and CDT codes.
• Internet access provided by a cable or fiber provider with 40 MB download and 10 MB upload speeds.
• Home router with wired Ethernet (wireless connections and hotspots are not permitted).
• A designated room for your office or steps taken to protect company information (e.g., facing computer towards wall, etc.)
• A functioning smoke detector, fire extinguisher, and first aid kit on site.