Medical Claims Auditor – MD

The Firm seeks an experienced Medical Claims Auditor for our Bethesda, Maryland office to work with our professional audit teams for employee benefit plan attest clients.  A successful candidate will effectively communicate with fellow team members and our clients and assure accuracy of claims processing by carrying out detailed analyses and utilizing problem solving skills.  The candidate will work alongside staff, managers, and partners, and will be provided with ongoing feedback to promote learning and growth. 

 

Responsibilities:

  • Audit, review and readjudicate medical, dental, pharmacy and vision claims.
  • Identify, research, and resolve issues in accordance with plan documents.
  • Maintain quality and turn-around goals.
  • Responsible to complete both individual and team-oriented tasks.
  • Interface with and establish rapport with client personnel to obtain information and system access pertinent to the audit process.
  • Prioritize competing work demands and concurrent projects and manage time appropriately.
  • Represent the Firm in a positive light by maintaining a professional demeanor, dress, and attitude at all times.
  • Follow established procedures, but suggest innovative, progressive ideas where appropriate.
  • Maintain the highest of ethical standards.

 

Qualifications:

  • Associates Degree in Business, Accounting, or a related field.
  • 5+ years’ related work experience (medical coding a plus).
  • Excellent oral, written, and interpersonal communication skills.
  • Flexibility to travel to client locations, primarily in the Metropolitan Washington DC area, and potentially to other Firm offices in New York City and Little Falls, New Jersey.
  • Must have own transportation to visit client locations.