ColoradoSpringsRecruiter Since 2001
the smart solution for Colorado Springs jobs

SIU Provider Auditor / Provider Auditor Sr.

Company: Anthem, Inc
Location: Colorado Springs
Posted on: February 16, 2020

Job Description:

SIU Provider Auditor / Provider Auditor Sr. - PS32633Location: Cerritos, California, United StatesRequisition #: PS32633Post Date: Jan 23, 2020Your Talent. Our Vision. At Anthem, Inc., its apowerful combination, and the foundation upon which were creating greater accessto care for our members, greater value for our customers, and greater healthfor our communities. Join us and together we will drive the future of healthcare .Thisis an exceptional opportunity to do innovative work that means more to you andthose we serve atoneof America's leading health benefits companies and a Fortune Top 50 Company.SIU Provider Auditor or SIU Provider Auditor Sr.Cerritos, CA - will also consider a remote arrangementAs an auditor for the Special Investigation Unit (SIU) this position conducts reviews of medical charts, medical notes, itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider reimbursement policies, and industry standards. Primary duties may include, but are not limited to:

  • Selects providers that are flagged to be reviewed based on a pre-pay basis using historical results of other reviews with providers, aberrant patterns of billing, network management input and dollar volume of provider.
  • Verifies dollar amount on claim is correct in claims system and writes report of the findings of the review and requests payments for any over payments.
  • Identifies aberrant patterns of billing and detects potential abuse. Mentors and trains Provider Auditor as needed.
  • Drafts department policies and procedures and other educational materials.
  • Works on task forces and committees representing functional area.Provider Auditor:Requires either a BA/BS degree, medical coding certification (CPC), 2-4 years equivalent work experience; or any combination of education and experience, which would provide an equivalent background.Provider Auditor Sr.:Requires either a BA/BS degree, medical coding certification (CPC), 5 years equivalent work experience; or any combination of education and experience, which would provide an equivalent background.Medicare claims experience is required for both job levels.Preferred skill sets include:
    • RN degree
    • Strong written and verbal communication skills
    • Intermediate knowledge level of Microsoft Office (Word, Excel, Outlook)
    • Familiarity with coding software (i.e. EncoderPro)
    • Member of Health Care Anti-Fraud Associate (HCAFA) or FWA certificationAnthem, Inc. is ranked as one of AmericasMost Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityIncmagazine Top 50 Company for Diversity. To learn more about our company andapply, please visit us at An Equal Opportunity Employer/Disability/Veteran.

Keywords: Anthem, Inc, Colorado Springs , SIU Provider Auditor / Provider Auditor Sr., Accounting, Auditing , Colorado Springs, Colorado

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Accounting, Auditing Jobs

Internal Auditor (Senior)
Description: Position: --Senior Internal Auditor -- Position Overview: As a Senior Internal Auditor, you will assist in the internal audit initiatives as well as perform audits in accordance with the annual audit (more...)
Company: Eliassen Group, LLC
Location: Denver
Posted on: 02/26/2020

Senior Accounts Payable Specialist
Description: OverviewWho Is Simpson Housing/Simpson Property Group --Headquartered in Denver, Colorado we are a large, fully integrated real estate company with a rich and successful history dating back to 1948.-- (more...)
Company: Simpson Housing LLLP
Location: Denver
Posted on: 02/26/2020

Description: JOINT INTEREST BILLING JIB MANAGERExcellent opportunity to get in with one of Denver---s top companies as their Joint Interest Billing Manager The company offers a great work life balance, stability (more...)
Company: Trimble & Associates, Inc.
Location: Denver
Posted on: 02/26/2020

AR Specialist
Description: DescriptionRobert Half is partnering with a company located in the Englewood area to staff a position as an Accounts Receivable Specialist. The Accounts Receivable Specialist will be responsible for the (more...)
Company: Robert Half Finance & Accounting
Location: Englewood
Posted on: 02/26/2020

Contract Accounting Analyst
Description: Tasks Identify and run raw data reports Compare data between two systems Identify
Company: J2T Recruiting Consultants
Location: Boulder
Posted on: 02/26/2020

Admin Assistant/ Accounting Manager
Description: Our Client in Greeley--is looking for an Administrative Assistant. This position provides support and assistance to executives that ensure effective use of time and productive interactions with staff (more...)
Company: ConcurrentHRO
Location: Greeley
Posted on: 02/26/2020

Global Accounting/Finance Manager
Description: DescriptionRobert Half Finance and Accounting is partnering with an international company in northern Colorado searching for a Global Accounting/Finance Manager. This will be the top finance person for (more...)
Company: Robert Half Finance & Accounting
Location: Lafayette
Posted on: 02/26/2020

Project Controller / Admin
Description: Posting TitleProject Controller / Admin.LocationCO - Golden.Position TypeRegular.Hours Per Week40.Job DescriptionThe National Renewable Energy Laboratory NREL is a leader in the U.S. Department of Energys (more...)
Company: Nrel
Location: Golden
Posted on: 02/26/2020

Controller Accountant
Description: Basic Function: The controller position is accountable for the accounting operations of the company, to include the production of periodic financial reports, maintenance of an adequate system of accounting (more...)
Company: HireSparks AV Recruiting
Location: Denver
Posted on: 02/26/2020

Accounting contractor
Description: Seeking a contractor to start
Company: 361 Services
Location: Boulder
Posted on: 02/26/2020

Log In or Create An Account

Get the latest Colorado jobs by following @recnetCO on Twitter!

Colorado Springs RSS job feeds