The Jacobson Group Saint Louis, MO
Job Description
Job Responsibilities – The auditor will uncover issues with the way the system is linking the providers fee schedules. The auditor would look at the claims for any alterations (i.e. Modifiers billed but not keyed, denials applied to the claim in error resulting in an underpayment, incorrect data entry not corrected before finalizing resulting in overpayments etc.) This position is not looking at coding or editing. Just reading and applying the policy against the examiners’ action that altered the payment and whether it was supported by the policy and whether the fee schedule on the provider file is interfacing accurately with the claim.
Handling IL and MI Medicaid: Working on MCS. The goal will be to audit up to 30 claims per day when they are trained. The project is set to go until a minimum of January 2022.
Skill Set /Experience Requirements–
1. Seasoned claims experience either in auditing, configuration, testing or other claims specialties
2. Previous experience with audit or system checking of some level
3. Problem Solver and Critical Thinker
Company Description
The Jacobson Group is the leading provider of insurance talent. For 50 years, we have been connecting insurance organizations with professionals from the board room to the back room on both a permanent and temporary basis. We offer a variety of solutions including executive search, professional recruiting, RPO, temporary staffing, subject matter experts, and onsite and work-at-home operations support. Regardless of the need or situation, Jacobson is the insurance talent solution.
The Jacobson Group
Why Work Here? This company is very reputable and have a great pay structure. On top of the salary, there is an opportunity to make 15K+ is bonuses as well
The Jacobson Group is the leading provider of insurance talent. For 50 years, we have been connecting insurance organizations with professionals from the board room to the back room on both a permanent and temporary basis. We offer a variety of solutions including executive search, professional recruiting, RPO, temporary staffing, subject matter experts, and onsite and work-at-home operations support. Regardless of the need or situation, Jacobson is the insurance talent solution.