Results-driven and detail-oriented Medical Claims Audit Officer with experience in conducting audits, reviewing medical claims for accuracy and compliance, and identifying discrepancies. Seeking a challenging role where I can utilize my skills to ensure the integrity of claims processing. I seek challenging opportunities where I can fully use my skills for the success of the organization.
-Review and process insurance claims for accuracy and completeness
-Verify policy information and coverage to determine claim eligibility
- Investigate and resolve discrepancies in claims to prevent delays in processing
-Perform audits on medical claims to verify accuracy, completeness, and compliance with regulatory requirements
-Develop audit reports and recommendations for process improvement and compliance enhancement - Ensure compliance with insurance regulations and company policies - Meet productivity and quality standards for claims processing