Shutterfly
photos • photo books • cards & stationery • gifts • share sites
10,000+ employees
Founded 1999
💰 $20M Series F on 2005-12
Clinical Claims Auditor
December 3
🇺🇸 United States – Remote
💵 $41.4k - $62.4k / year
⏰ Full Time
🟡 Mid-level
🟠 Senior
🔎 Auditor
🗽 H1B Visa Sponsor
Shutterfly
photos • photo books • cards & stationery • gifts • share sites
10,000+ employees
Founded 1999
💰 $20M Series F on 2005-12
Description
• Examines provider claims and service authorizations for completeness, accuracy, and medical necessity • Proposes resolutions per internal and regulatory processes • Communicates to relevant teams and providers any claims/ authorization inaccuracies found along with recommended solutions • Follows up to ensure outstanding issues are resolved and to increase and promote overall satisfaction • Compiles recurring issues to help educate teams on error prevention • Completes documentation in Patient Health Information database (CCMS) and in accordance with all other company procedures • Additional duties as required
Requirements
• HS Diploma or GED from an accredited institution • experience with Outlook and MS Office • Good communication skills • Strong attention to detail • Relevant previous work experience including but not limited to claims, service authorizations, health insurance, and Medicaid managed care products. • Healthcare industry experience • Experience working with Claims and Providers
Benefits
• medical, dental and vision coverage • incentive and recognition programs • life insurance • 401k contributions
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