HC & Insurance Ops Sr. Assoc
Dell Financial Services L.P. - Quincy, MA

This job posting is no longer available on Dell Financial Services L.P.. Find similar jobs: Dell Financial Services jobs

Job Responsibilities:
The candidate will be responsible for auditing medical claims on a pre-payment basis in accordance with documented Claim Processing Guidelines, Contractual Terms, Plan Payment and Benefit Policies.

They should be able to comprehend and apply provider contract language.

This person is responsible to document audit results in a FOXPRO database for tracking and feedback purposes.

The auditor is responsible to conduct a preliminary root cause analysis for errors found, identify systemic quality issues, and follow-up with internal departments as necessary.

Auditors are responsible to attain and are measured against predetermined Quality and Productivity standards within the department as well as deadlines for completion of all audits and administrative tasks.

Qualifications

Required Skills:
3 to 5 years experience with medical claim processing systems and/or procedures

Familiarity with medical coding including CPT, HCPCS, ICD9, and DRG coding

Understanding of electronic claim processes

Demonstrated Analytic Ability

Excellent written and oral communication skills

Excellent organization skills

Desired Skills:
Hospital (UB04), Physician (CMS1500) Medical Claim Audit, Processing, or Billing Experience

Familiarity with hospital contract language, methodologies and reimbursement policies

Knowledge of industry standard code review editing software

Prior Audit experience helpful

Minimum Educational Requirements:
High School Graduate

Dell is an Equal Opportunity Employer.

To learn more about our commitment to Diversity & Inclusion, visit:

Equal Employment Opportunity Policy Statement

Life at Dell

Learn about Dell culture, the interviewing process and benefits offered in your location:

Life at Dell

Dell Financial Services L.P. - 23 months ago - save job - copy to clipboard
About this company
1,531 reviews
Since 1985, Dell has played a critical role in enabling more affordable and accessible technology around the world. As an end-to-end...