Note: The job is a remote job and is open to candidates in USA. KYYBA Inc is a leading company in Healthcare, seeking talented Consultants to join their growing team. The Claims Audit Project Coordinator will support audit processes, manage inquiries, and ensure accurate documentation related to claims.
Responsibilities
- Supports audit by retrieving, validating, and compiling documentation from claims systems to meet quality and deadline requirements
- Partners with internal teams to respond to audit inquiries, resolve gaps, and ensure accurate submissions
- Tracks and manages audit inquiries and deliverables, proactively identifying risks and ensuring timely completion
- Conducts detailed claim reviews to validate audit samples and investigate errors
- Determines appropriate documentation to support claim payments
- Monitors implementation of corrective actions to ensure resolution
- Communicates findings clearly, both verbally and in writing, and prepares and refines audit responses to ensure accuracy and clarity
- Support audit coordination for group customer accounts requesting claims accuracy reviews
- Responsibilities include managing inbound audit requests, coordinating documentation and issue tracking
- Will facilitate communication between customers and operational teams
Skills
- Healthcare experience including claims/benefits
- Project/Workflow Coordination
- Communication Skills
- Healthcare experience including medical claims and Medicare Advantage product
- Strong knowledge of CMS rules and regulations
- Advanced Project Management
- Strong Communication Skills
- Familiarity with medical claims or benefits (MA or Commercial)
- Knowledge of CMS rules and regulations
- Strong Project Management
- Knowledge of medical claims or benefits (MA or Commercial)
- Strong Communication Skills
- Project management Skills
- Bachelor's degree in Business Administration, Healthcare administration, Accounting, Finance or related field required
- Knowledge of IKA or NASCO claims processing systems
- Strong excel
- Experience with Data Validation
Benefits
- Medical, dental, vision
- 401k
- Term life
- Voluntary life and disability insurance
- Optional Pre-paid legal plan
- Optional Identity theft plan
- Optional Medical and dependent FSA
- Work-visa sponsorship
- Opportunity for advancement
- Long-term assignment with opportunity for hire by client
Company Overview