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CLAIMS AUDITOR - PHP

Company: Presbyterian Healthcare Services
Location: Albuquerque
Posted on: February 15, 2019

Job Description:

About UsPresbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of eight hospitals, a statewide health plan, and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees. Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans. We are part of New Mexico's history and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come. Job Description Type of Opportunity: Full TimeFTE: 1.000000Exempt: NoWork Schedule: Weekday Schedule Monday-FridayLocation: Rev Hugh Cooper Admin Center Education:
Essential:
* High School Diploma or GED
Minimum Requirements:
High School Diploma (or G. E. D.) plus short-term training required, two years of college-level courses/associates degree preferred. Three years claims auditing experience OR five years in claims processing for a managed care organization; including coordination of benefits, subrogation, and payment refunds and recovery. Excellent organizational, problem solving, verbal, written communication, negotiation skills and the ability to interact with other functional areas required.
Summary:
The Claims Auditor is responsible for all activities related to Claims Transaction audits by means of identifying, documenting, and communicating inaccurate information. The Claims Auditor must also create, maintain and provide statistical audit reports, documentation and direction for claims and the CARE Units. Benefits Benefits are effective day-one (for .45 FTE and above) and include:

  • Competitive salaries
  • Full medical, dental and vision insurance
  • Flexible spending accounts (FSAs)
  • Free wellness programs
  • Paid time off (PTO)
  • Retirement plans, including matching employer contributions
  • Continuing education and career development opportunities
  • Life insurance and short/long term disability programs About New MexicoNew Mexico--s unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque--s International Balloon Fiesta, Los Alamos-- nuclear scientists, Roswell--s visitors from outer space, and Santa Fe's artists and you get an eclectic mix of people, place, and experiences that make this state great. Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC. New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding, and boating, it's all available among our beautiful wonders of the west. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

    Keywords: Presbyterian Healthcare Services, Albuquerque , CLAIMS AUDITOR - PHP, Accounting, Auditing , Albuquerque, New Mexico

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