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Job Details

Insurance Claims Auditor

Company name
Marquee Staffing

Irvine, CA

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Job Description
Are you looking to join a stable company that is experiencing a tremendous amount of growth, values your contribution, and provides you with a career rather than just a job?
• Lead team to maximize office collections, communicate issues and implement guidelines/parameters to improve processes. • Analyze various internal and external reports to review/trace outstanding and complex claim payments, request additional information from practices, make claim corrections, re-submit, and appeal with carriers for proper revenue. • Identify strategic financial solutions for regional operation managers to drive higher percentage of payments and faster billing cycles. • Analyze and develop billing metric scorecards to identify offices that need training or billing process improvements. • Train regional leaders on best practices and more efficient billing processes. • Perform daily activities of auditing and billing of assigned practice’s patient claims to ensure accurate and maximum reimbursement for patient treatment from insurance carriers. • Analyze Explanation of Benefits (EOB) statements and adjust accounts according to PDS claims processing criteria. • Identify necessary adjustments to accounts and use negotiation skills to obtain claims approval and payment information from various carriers. • Review and examine Aging Collection Report to ensure accounts are properly billed to the insurance. • Weekly, check the portals (e.g. Request for Information (RI), and Claims Portal) to ensure that any missing information is obtained, so that the claims are billed properly; • Partner with Regional Manager and Operations Manager of assigned practices to provide feedback and education around maximizing the regions and offices collectable revenue. • Communicate trends and suggestions to improve processes to ROC, OMs, and Regional Managers. • Other duties as assigned by management.

Job Requirements
We seek outstanding professionals that possess the following qualifications:
• Bachelor’s degree in Finance, Business Administration or related field preferred. In lieu of degree, 4 years of claims auditing or related experience. • Strong computer and data entry skills with competent knowledge of Microsoft Word and Excel software applications. • Excellent interpersonal communication skills. • Experience working with QSI (Quality Systems Inc.) preferred but not required.

Company info

Marquee Staffing
Website :

Company Profile
For more than fifteen years, Marquee Staffing has built a reputation on expert local market knowledge, unparalleled personalized service and the ability to deliver winning candidates and job opportunities. Marquee operates three offices located conveniently throughout Southern California. Each branch is full-service, providing temporary, contract, contract-to-hire and direct placement services for a diverse set of clients. Each branch has recruiters who specialize in key industries, ensuring that our clients get the best match possible for each open position and that our candidates get expert guidance in their career path. Most recently, Marquee Staffing has added technology to provide additional value for our clients, employees and candidates. Our online assessment center is one of the most comprehensive available, allowing candidates to test their skills at their convenience and from the comfort of home. My Marquee, an online service center for candidates and employees, provides desktop access to their Marquee records. My Marquee enables quick and easy updating of personal information and professional aspirations, availability and experience. Marquee will continue to upgrade technology and will soon offer fully automated, online timecard submission and approval, HR-related report tools for our clients and many other features powered by the latest staffing software on the market. All of these technological enhancements will help us assist our client companies and candidates better, and will complement the personal service that Marquee is known for and continues to provide.

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