Production Claims Auditor - Franklin, TN - (Franklin, TN)

Welcome to 1 of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM Main responsibilities: Audit members and paid claims data Investigate and resolve errant payments on all claims types, as well as assist in resolution for health plans, commercial customers, and government entities as needed Examine, assess, and document business operations and procedures to ensure data integrity, data security and process optimization Initiate phone calls to providers, employer groups, and other insurance companies to gather pertinent claim info e.g., verification of member policies, confirmation of services received, and coordination of benefits details Work directly with other departments to enhance and refine assigned inventory to maximize value Ensure adherence to state and federal compliance policies