Claims Auditor Jobs description

A claims auditor job involves claims auditing including analyzing payments, procedures and guidelines of benefits. A claims auditor interprets detailed paid claims reports, eligibility reports, payment reports, and other various reports to determine the eligible types of services. A claims auditor monitors claim financials and/or sets reserves; performs routine follow ups for all pending claims and open reserves; and reviews all aspects of claims liability and accurately adjudicates the claim according to complex contractual obligations. A claims auditor job will also maintain quality, quantity, and turn-time standards.

A claims auditor job requires a bachelor’s degree in accountancy or commerce along with 3+ years of claims auditor experience. Good analytical and problem solving skills, and ability to exercise good judgment in complex or difficult claim situations is important. A claims auditor must have strong sense of individual responsibility and service to both the customer and company, and also have ethical values. A claims auditor must have data management ability and knowledge in computers, including MS Excel and MS Word.

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