Get new similar jobs by email for

Medical - Claims Auditor (HMO)

By continuing you agree to Monster's Privacy policy, Terms of use and use of cookies.

Confidential Posting


Job Summary

Tarzana, CA
Healthcare Services
Financial Services
Job Type
Full Time
Years of Experience
2+ to 5 Years
Career Level
Experienced (Non-Manager)

Medical - Claims Auditor (HMO)

About the Job

  1. Audit of claims to alleviate any incorrect decisions
  2. Maintain a record of audit results
  3. Submit errors back to the proper source
  4. Review, research, and resolve complex claims processing issues
  5. Other duties and special projects as specified by the Director/​Supervisor



At Least 5+ Years Experience examining claims with 5+ years of Managed Care HMO experience

Experience with HMO, Managed Care, Medicare, Medi-Cal, Commercial, Senior, DRG/RCC rates, ICD-9, anesthesia claims, in-patient claims, SNF, DME, dialysis, chemo, stop loss or case rates, COB, outpatient surgeries, ER and all other claim types



Job Tools