Job Description

Bachelor’s degree in Healthcare Management, Finance, Business Administration, or a related field.

Relevant professional certification in auditing, medical billing, or healthcare management is preferred.

Previous experience in healthcare claims management, insurance auditing, or revenue cycle management is preferred.

Strong knowledge of medical claims processing, claims adjudication, billing procedures, and insurance policies.

Experience conducting audits, identifying discrepancies, and ensuring compliance with healthcare regulations and payer guidelines.

Ability to analyze claims data, investigate errors, and implement corrective measures.

Strong leadership, analytical, problem-solving, and decision-making skills.

Excellent communication and team-management abilities.

Proficiency in claims management systems, reporting tools, and audit documentation.