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Medical Claims Auditor Position

American Benefit Corporation
Ona, WV Full Time
POSTED ON 2/8/2025
AVAILABLE BEFORE 3/9/2025

Job Description

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The American Benefit Corporation is seeking a skilled Claims Auditor to join our team. As a key member of our organization, you will be responsible for examining claims and determining benefits in accordance with plan provisions.

Key Responsibilities:

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  • Examine claims and determine benefits in accordance with plan provisions
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  • Follow through on problems or requests resulting from phone inquiries in accordance with policies and procedures
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  • Provide claim totals to appropriate parties for bank transfers as needed
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  • Maintain up-to-date claim information in group binders
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  • File reinsurance claims for stop loss reimbursement
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  • Test new groups or new benefits, which have been entered into the claims adjudication system for accuracy
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Requirements:

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  • Knowledge of all Microsoft Office programs
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  • Familiarity with medical terminology, including anatomy
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  • Ability to multi-task and concentrate in a large office environment
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  • Bachelor's Degree in related field is preferred
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