Job Title
Health Claims Audit Consultant
Job Profile
A Health Claims Audit Consultant helps clients improve the performance of their health benefit plans and the services provided by their health plan administrators. To fulfill this role in our Los Angeles, the Claims Audit Consultant will:
Lead project teams and conduct operational, claims and customer service audits of health plan administrators
Develop solutions to meet client needs for their health benefits programs
Evaluate vendor performance and identify improvement opportunities
Provide substantive written reports to clients
Provide a variety of specialized evaluations and solutions to help clients improve their plan performance
Conduct claims and customer service administration vendor site visits; manage on-site audit project team.
Develop new business, prepare proposals and client presentations on Mercer's audit services.
','!*!A Health Claims Audit Consultant helps clients improve the performance of their health benefit plans and the services provided by their health plan administrators. To fulfill this role in our Los Angeles, the Claims Audit Consultant will:
Lead project teams and conduct operational, claims and customer service audits of health plan administrators
Develop solutions to meet client needs for their health benefits programs
Evaluate vendor performance and identify improvement opportunities
Provide substantive written reports to clients
Provide a variety of specialized evaluations and solutions to help clients improve their plan performance
Conduct claims and customer service administration vendor site visits; manage on-site audit project team.
Develop new business, prepare proposals and client presentations on Mercer's audit services.
','!*!
BA/BS degree or comparable industry experience
Eight or more years' progressive experience in-group health claims operation with a major insurance carrier or TPA
Strong technical knowledge of group health claims and administration
Supervisory experience as well as experience in medical claim processing
Solid oral and written communication skills
Ability to travel 20% to 30%
Job URL
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Location: USA-CA-Los Angeles |
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Date Last Verified
Sep 06,2010 |
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Posted on
Jul 29,2010 |
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Company info
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