Operations Auditor
The Carle Foundation - Urbana, IL

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Position Summary: Conducts detailed reviews of claims, enrollment, recovery and/or system configuration to measure and report accuracy of these operational activities on an individual, group, or plan-wide basis as needed. Communicates audit findings to appropriate management and staff, and assists in the development of corrective action plans in response to unfavorable audit results. Works with external auditors as necessary in their review of claims, recovery, enrollment and/or system configuration. Completes specialty audits on a routine or ad hoc basis as directed by management.

Experience: Two years experience in managed care systems and/or operations or audit of the same. One-year experience on the computer, preferably using managed care PC software.

Other Knowledge/Skills: Must possess a high level of mathematical aptitude. Must be thorough and detail oriented. Should have strong comunication skills and be adept at persuasion and problem-solving. Ability to plan, prioritize and work well independently.

The Carle Foundation - 2 years ago - save job