Auditor Claims BCI at Brokerage Concepts in Blue Bell, Pennsylvania

Job Description:

Responsible for the monitoring and auditing of medical, dental, vision, healthcare reimbursement claims and flexible spending claims processed by the HNAS claims team. Works to ensure that all internal operating and administrative procedures are being applied accordingly to each claim. Handle ongoing auditing of the internal process for correspondences and the hitching/indexing process.
Assist the supervisors with the specialized auditing for various vendors, carriers and employer claims audits.
Review, understand and adhere to all plan wording to manage all audits accurately and timely. Assist the claims team in processing claims during backlog situations, which includes but not limited to management of correspondences, customer service intakes/inquiries and all procedures related to claims. Able to assist with specialized projects, which include but not limited to, eligibility audits, plan documents audits, SOC audits and system upgrade reviews.
This position is responsible for understanding all claims processing policies, sufficient to identify issues and coach claims reps for improvement.
Auto req ID
2798BR

Knowledge and Skills
Comprehensive understanding of CPT, HCPCS, ICD9 and ICD10 medical coding Strong attention to details along with organizational skills Excellent problem solving with the ability to work in a fast paced production environment Excellent communication skills both verbal and written PC navigation skills for Professional work environment Basic MS Excel Basic MS Word Ability to use judgement to make sound decisions referencing all available resources Ability to work independently and also as part of a team

Qualifications
Problem Solving Skills: Ability to research and seek assistance through all available resources, to ensure resolution on claim audits. Must be able to multi-task and follow up at appropriate intervals. Raise concerns to the management team on situations and/or issues in a timely manner.

About Us
HealthNow Administrative Services (HNAS) is a wholly-owned subsidiary of HealthNow New York, Inc., a health insurance carrier headquartered in Buffalo, New York. With offices in Pennsylvania, New Jersey, Arizona and California, HNAS is a nationally recognized group benefit plan marketer and administrator. HNAS specializes in custom-designed employee benefit programs and Third Party Administration (TPA) and partner services, self-funded health insurance, and consumer driven health care plans as well as health management solutions. HNAS provides employee benefit solutions integrated with administrative and claims services. For more information, you can visit www.hnas.com. HealthNow Administrative Services (HNAS) is a wholly-owned subsidiary of HealthNow New York, Inc., a health insurance carrier headquartered in Buffalo, New York. With offices in Pennsylvania, New Jersey, Arizona and California, HNAS is a nationally recognized group benefit plan marketer and administrator. HNAS specializes in custom-designed employee benefit programs and Third Party Administration (TPA) and partner services, self-funded health insurance, and consumer driven health care plans as well as health management solutions. HNAS provides employee benefit solutions integrated with administrative and claims services. For more information, you can visit www.hnas.com.

Company
HealthNow Administrative Services

Job Category
Customer Service/Provider Services/Claims

Status
Full Time Regular

Experience
5 years prior medical dental, vision, FSA and HRA claims processing experience. Preferred: Associate Degree

EEO Statement
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

Hours
As Required

Education
Required Education:HS/GED (N/A)

Position Posting Location
Blue Bell

State
Pennsylvania