Auditor II – Data Mining

This is a fully remote position, open to applicants in United States.

📋 Description

• Analyze query outputs related to overpayments.

• Adhere to Query Step-by-Step Documentation to confirm overpayment validity.

• Leverage claims systems, if applicable, to validate overpayments.

• Record overpayments and non-overpayments in production systems, providing clear explanations for claims deemed not overpaid.

• Achieve quality and production benchmarks.

• Log production activities and time following the format specified by Management.

• Report any issues that could hinder the timely completion of assigned tasks to Management.

• Collaborate with Management to address and resolve issues.

• Offer constructive feedback to Management regarding potential areas for improvement.

⛳️ Requirements

• High School Diploma or equivalent is mandatory.

• College degree or relevant work experience is preferred.

• Must maintain OIG/GSA clearances.

• Strong attention to detail is necessary.

• Exceptional written and verbal communication skills are required.

• Must be adaptable during periods of change, with the ability to adjust to evolving priorities and timelines through analytical and problem-solving skills.

• Capability to learn, comprehend, and apply new technologies is essential.

• Familiarity with CMS guidelines is required.

• Strong understanding of HCPC, CPT, and other coding methodologies is necessary.

• Proficient in spreadsheet, word processing, and database applications.

• Preferred: 1-2 years of experience as an Auditor.

• Preferred: 1-2 years of experience in Medical Claims Processing.

🏝️ Benefits

• Benefits information can be found at https://www.exlservice.com/us-careers-and-benefits.

• Opportunity to work from home.