SENIOR PLAN AUDITOR
POSITION SUMMARY
The Senior Plan Auditor is responsible for testing and auditing the builds of the plan coders as needed for all new and existing revisions.
ESSENTIAL FUNCTIONS
- Log all new groups and plan changes on spreadsheets as they are received
- Audit main coverage area’s through a GPL report
- Accurately test the indicated new groups/plan changes in conjunction with the GPL report
- Keep monthly tracking and trending reports based on testing/auditing results
- Review the incoming plan building referrals and send to plan building if valid
- Track and log all incoming plan building referrals monthly
- Audit Assurant Plans as they are coded
- Assist with various projects on an as-needed/availability basis
- Performs other related duties as assigned
EDUCATION
- Bachelor’s degree or equivalent work experience required.
EXPERIENCE AND SKILLS
- 5 years Medical/Dental Claims experience required.
- Some exposure to plan coding would be helpful.
- Must be proficient in both Microsoft Word and Excel.
- Must be able to work both independently and with a group to complete the necessary objectives of this position.
- Must be able to work under pressure to meet certain deadlines, as well as, being able to effectively manage workload in a timely manner.
- Well organized and have good communication skills both written and verbally.
POSITION COMPETENCIES
- Time Management
- Accountability
- Communication
- Initiative
- Customer Focus
PHYSICAL DEMANDS
This is a standard desk role - long periods of sitting and working on a computer are required.
WORK ENVIRONMENT
Remote
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.