Entry Level Auditor Resume - Specialist's opinion

clearlyClaims Auditors check the validity and accuracy of policyholder claims, thus ensuring the profitability of insurance companies.

Essential work activities listed on a Claims Auditor example resume are applying auditing standards, checking the correctness of claims, approving or denying claims, and justifying their decisions. Based on our collection of Claims Auditor resumes, main job requirements are knowledge of claim auditing procedures, accuracy, confidentiality, decision-making, computer competences, and effective communication.

How to get Accounting Job Experience (Entry Level)

Most candidates have a four-year college degree in auditing, accounting, or finance. Looking for job listings?

Check out our Claims Auditor Jobs page. Process incoming driver's logs per vendors regarding daily trips per patient's medical appts.

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Upload your resume and within 48 hours TopResume will email you a detailed analysis of what hiring managers and automated systems think of your resume — and how to improve it. Answer phones and email per patients and vendors regarding reimbursement Print drivers logs for daily review for in order to approve trips taken for reimbursement Reprocess reimbursement checks and clear through management, if needed Mail out reimbursement checks to vendors and or patients as needed Verify mileage via MapQuest and verify reimbursement checks were deposited via Oracle.

Knowledge of UB04 and claim forms. Work Discrepancy Report to determine types of discrepancies and assign appropriate reason Experienced with all payers including Medicare, Examine UB and claims for accuracy and correct codes for click reimbursement. Reviewed and followed up audit suspense reports to ensure all pending claims met departmental turnaround time.

Worked with worker's compensation and TPL claims. Audit automobile and motorcycle mechanical repair claims per insurance contract guidelines.

Assist dealership personnel in reconciling claims payable accounts and review claim payment explanations. Coding of the Claims to get them ready for keying into the computer Entering the Claims into the database, getting them prepared for payment.

Set claims reserves and adjusts as needed.

Keep the reserves current. Refer large dollar claims and trigger diagnosis to preliminary claims and case management departments. Worked as part of a team to reduce backlogged adjustment volume subsequent to transition to QNXT system. Communicates and works effectively within a team and individually to complete various special projects within set time lines. Maintains the highest level of privacy.

Proactively communicates with other departments to ensure cross-functional concerns are identified and addressed.

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Works collaboratively with all internal and external customers. Identify opportunities to enhance plan policies and align with cost containments initiatives. Review and correct UB 04 inpatient and here billing and coding errors when appropriate especially in regards to all the new biological drug treatments.

Regular communication with clients and insurance provider representatives coordinating efforts to identify variance trends and causes. Working with auditors across projects to consult on clinical matters. Bachelor of Science in Nursing. Your resume has been submitted successfully!

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