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Claims Audit Analyst

locationMaryland - Maryland (MD),

atPiper Companies

Estimated salary $42,000 - $52,000 a year

Job Description:

Piper Companies is actively seeking candidates for a remote Claims Audit Specialist to support a nationwide healthcare insurance company. The Claims Audit Specialist will work directly with the Compliance & Quality Assurance department to analyze and identify gaps in claims processing across the company.

Responsibilities for the Claims Audit Specialist include:

  • Analyze claims processing data and identify common errors and potential gaps in claims processing protocols
  • Develop recommendations for process improvement based on audit findings and provide feedback to individual claims team members and department leaders
  • Conduct ongoing quality reviews of current claims queues to ensure correct processing of ongoing incoming claims
  • Conduct quality review of functions performed and maintain documentation mandated by control activities and financial audits
  • Engage in department projects to ensure work performed is accurate, complete, and improved
  • Provide feedback
to improve how employees and departments can eliminate repeated errors
  • Act on corrections to policies, systems, and procedures to establish a higher quality of work is performed

  • Requirements for the Claims Audit Specialist include:

    • 1+ year of relevant experience in healthcare quality reviews and claims processing improvement
    • 2+ years of healthcare claims processing experience
    • High School Diploma or G.E.D. Required

    Compensation for the Claims Audit Specialist include:

    • Salary Range: $42,000 – $52,000 based on relevant experience
    • Benefits: Health, Dental, & Vision Insurance, 401K


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