Senior Medical Claims Auditor
Conduct assessments of medical claims to ensure compliance with eligibility criteria
Performs and supports all audits and assessments through phases of planning, pre-audit, fieldwork, and reporting
Researching and developing audit criteria, checklists, test/assessment strategies
Developing findings and recommendations
Supports junior personnel with complex audit tasks
Expertise in medical claims documentation
Knowledge of coding concepts
Knowledge of scope and statistical sampling methodologies
Quality assurance and coding risk analysis
Experience communicating results and findings
Ability to work with clients to understand their needs
Ability to maintain a positive relationship with customers and other vendors
Demonstrated ability to adhere to quality assurance processes to review and verify work for accuracy
Excellent written and oral communication skills
Professional presence is required
All candidates must be U.S. Citizens and be able to pass a Federal background investigation
Ability to obtain a Position of Public Trust
Certified Professional Medical Auditor (CPMA) certification
5+ Years of experience
Past experience working for a Federal Agency
Strong organizational and time management skills
Capability to work in a team environment, as well as independently
Possess motivation to learn new technologies and methodologies that demonstrate value
CSCI is an award-winning information technology and financial management consulting firm founded on one simple philosophy: “Do what is right, always.” We apply this philosophy across all elements of our growing business, from delivering world-class services for customers to providing an environment for associates that encourages personal and professional growth. At CSCI, work and fun aren’t diametrically opposed. Our goal is to hire people with proven track records and retain them with an energizing, diverse company culture. We value each associate’s natural drive to excel, and we provide them with the freedom to do things their way. CSCI seeks the best and brightest in the industry; those who are ready to move their lives and career forward. Join us today, and get excited about Mondays again!
Benefits of Working at CSCI
- Competitive Salaries
- 20 Days Paid Time Off (PTO), plus Paid Holidays
- Full Health Benefits Package including Medical, Dental, and Vision
- 401K Retirement Plan
- Team Building Events and Employee Parties
CSCI is an Equal Opportunity/Affirmative Action Employer
Minorities, females, veterans, individuals with disabilities, sexual orientation, and gender identity. While all candidates are considered, CSCI encourages the above individuals to apply.
CSCI is committed to helping individuals with disabilities to participate in the workforce and ensuring equal opportunity to compete for jobs. If you require an accommodation, please contact CSCI Human Resources for further assistance. For questions regarding the qualifications listed above, please contact the CSCI Talent Acquisition Team.
The above declarations are not intended to be an all-inclusive list of the duties and responsibilities of the job described, nor are they intended to be such a listing of the skills and abilities required to do the job. Rather, they are intended only to describe the general nature of the job.
We are an E-Verify employer where mandated by State or Federal contracts.