Claims Auditor

This is a Fully Remote Job 1. About Our Client:MedPOINT Management is an Independent Practice Association management company serving the greater Los Angeles area. The organization addresses the challenge of coordinating high-quality healthcare delivery across Southern California by managing provider networks and supporting healthcare operations. It emphasizes operational excellence and care coordination to impact patient outcomes in the region. 2. About the Opportunity:The Claims Auditor role is responsible for ensuring the accuracy and integrity of medical claims processing within a healthcare management environment. This position helps reduce financial risk by auditing claims for compliance and correctness, directly contributing to the organization's ability to manage reimbursements effectively and maintain regulatory compliance. 3. Responsibilities:Audit medical claims for accuracy, completeness, and payer guideline complianceAnalyze claims data to identify billing errors, overpayments, and underpaymentsConduct pre- and post-payment audits to ensure proper reimbursementDocument findings and prepare detailed reports for managementCollaborate with claims processing and provider relations teams to resolve discrepanciesMonitor claims trends and recommend process improvementsEnsure compliance with federal, state, and managed care regulations including coding standards 4. Requirements:Minimum 2 years of experience in claims auditing, processing, or healthcare billingStrong knowledge of ICD-10, CPT, and HCPCS codingFamiliarity with managed care, IPA, or HMO claims environments preferredProficiency with claims management systems and Microsoft Office SuiteExceptional attention to detail and analytical skillsExcellent written and verbal communication skillsCPC, CCA, or related coding/billing certification is a plus 5. Pay Range and Compensation Package:The pay range and compensation package for this role will be determined based on the candidate’s experience, skills, and other relevant factors. 6. Benefits & Perks:401(k) plan with matchingDental insuranceHealth insurancePaid time offParental leaveVision insuranceCompany partiesEmployee discountsOpportunity for advancementSavings bankTraining and developmentWellness resources Equal Opportunity Statement:Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.