DesMoinesRecruiter Since 2001
the smart solution for Des Moines jobs

SIU Provider Auditor / Provider Auditor Sr.

Company: Anthem, Inc
Location: Des Moines
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 careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

Keywords: Anthem, Inc, Des Moines , SIU Provider Auditor / Provider Auditor Sr., Accounting, Auditing , Des Moines, Iowa

Click here to apply!

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

I'm looking for
in category
within


Other Accounting, Auditing Jobs


Enterprise Testing Senior Associate
Description: Important Note During the application process, ensure your contact information email and phone number is up to date and upload your current resume prior to submitting your application for consideration. (more...)
Company: Wells Fargo
Location: West Des Moines
Posted on: 02/22/2020

Credentialed Tax Expert - CPA, Enrolled Agent or Practicing Attorney - Seasonal Remote
Description: OverviewIf you are a highly motivated individual with an active credential CPA x2F EA x2F Practicing Attorney and excellent communication skills, we need you to help our customers complete their taxes (more...)
Company: Intuit
Location: Ankeny
Posted on: 02/22/2020

Enterprise Testing Sr Associate
Description: Job DescriptionImportant Note: During the application process, ensure your contact information email and phone number is up to date and upload your current resume prior to submitting your application (more...)
Company: Wells Fargo
Location: West Des Moines
Posted on: 02/22/2020


Financial Controls Oversight Consultant - ITGC/ITAC
Description: Job Description Important Note: During
Company: Wells Fargo Bank
Location: Des Moines
Posted on: 02/22/2020

Credentialed Tax Expert - CPA
Description: Job DescriptionOverview If you are a highly motivated individual with an active credential CPA/EA/Practicing Attorney and excellent communication skills, we need you to help our customers complete their (more...)
Company: Intuit
Location: Des Moines
Posted on: 02/22/2020

Member Financial Services Intern
Description: At FHLB Des Moines, we work each day to develop an inclusive culture that supports and leverages the complexity of a diverse workforce.
Company: Fhlb Des Moines
Location: Des Moines
Posted on: 02/22/2020

Senior Financial Analyst- MercyOne System Office
Description: Position Type: Regular br br Scheduled Hours per 2 week Pay Period: 80 br br Primary Location: IA WEST DES MOINES MERCY WEST LAKES br br Job Summary: The Senior Financial Analyst serves (more...)
Company: Mercy Medical Center
Location: West Des Moines
Posted on: 02/22/2020

Credentialed Tax Expert - CPA
Description: OverviewIf you are a highly motivated individual with an active credential CPA x2F EA x2F Practicing Attorney and excellent communication skills, we need you to help our customers complete their taxes (more...)
Company: Intuit
Location: Ankeny
Posted on: 02/22/2020

Credentialed Tax Professional - CPA Enrolled Agent or Attorney - Seaso
Description: OverviewIf you are a highly motivated individual with an active credential CPA/EA/Practicing Attorney and excellent communication skills, we need you to help our customers complete their taxes using (more...)
Company: Intuit
Location: Des Moines
Posted on: 02/22/2020

Credentialed Tax Professional - CPA Enrolled Agent or Attorney - Seasonal Remote
Description: Job DescriptionOverview If you are a highly motivated individual with an active credential CPA/EA/Practicing Attorney and excellent communication skills, we need you to help our customers complete their (more...)
Company: Intuit
Location: Des Moines
Posted on: 02/22/2020

Log In or Create An Account

Get the latest Iowa jobs by following @recnetIA on Twitter!

Des Moines RSS job feeds