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Job Details

Manager Provider Data Audit - Military veterans preferred

Company name
Health Net, Inc.

Location
Chesterfield, MO

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Profile

Position Purpose: Manages the day to day operations of the audit area to accurately and timely audit provider data loads and provider claim projects. Develop and recommend procedures and systems to be used in audits throughout the organization.
Establish and maintain contact with all levels of management to ensure the implementation of approved audit report recommendations.
Verify the accuracy of organization records as they pertain to provider data.
Prepare reports of audits and presents findings to senior financial management and other executives.
Investigate and recommend corrective action where controls are weak.
Identify extraordinary trends and conduct root cause analysis.
Conducts audits and recommends revisions to existing procedures and processes, and may establish new procedures as appropriate.
Review audits performed by staff members to ensure they are conducted according to standards.
Assign, monitor, and review the progress and accuracy of assigned work.
Provide technical guidance on complex issues.
Perform special auditing assignments and investigations as directed by management.Education/Experience: Bachelor\u2019s degree in related field or equivalent experience. 3 years experience in accounting, claims accounting, provider data auditing or processing, medical billing or physician\u2019s office experience. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Company info

Health Net, Inc.
Website : https://www.healthnet.com

Company Profile
Health Net's mission is to help people be healthy, secure and comfortable.

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