Quality Control Auditor - Intermediate in Rancho Cucamonga, CA at APEX Systems

Date Posted: 9/9/2019

Job Snapshot

Job Description

Job #:  1006004

Quality Control Auditor

Rancho Cucamonga, California
Position Summary:
Ensures the integrity of outside medical payments for the Organization through verification of the accuracy of data-entered information and by auditing service related information and invoice adjudication/payment for compliance with contract terms and Department and Regional Policies and Procedures.
Duties:

  • Auditing Hospital and Medical office encounters daily, and provides findings to the Director.
  • Ensures that audit staff tests payments for accuracy according to departmental policies and management guidelines.
  • Traces sources of inaccuracies; reports and proposes remedial action to appropriate management.
  • Ensures charity Care (MFA) encounters Prepares formal statistical summaries to department manager of findings and recommendations.

Education/License/Certification: 
  • Bachelors degree, or equivalent experience, in Business Administration or related field.

Qualifications:
  • Minimum of 1-5 years of auditing experience.
  • Proficient knowledge of mainframe, on-line computer systems, personal computers and spreadsheet and word processing programs.
  • Strong mathematical skills.
  • Medical terminology and knowledge of medical billing practices Prior experience in account payable/claims environment preferred.
  • Good oral and written communication skills.

 
 
 
 
 
 
 
 
EEO Employer
Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178-6178.