Rutgers New Start Career Network

Rutgers Edward J. Bloustein School of Planning and Public Policy mobile logo
New Start Career Network mobile logo

Job Information

WithumSmith+Brown, PC Health Claims Audit Manager in All NJ locations, New Jersey

Looking to work at a firm with an unbeatable culture? Withum is a forward-thinking, technology-driven advisory and accounting firm, helping clients to Be in a Position of StrengthSM in today’s modern business landscape. Withum empowers clients with innovative tools and solutions to address their accounting, tax and overall business management needs. Withum is a place where talent thrives. We recruit only the best and brightest people, with a genuine passion for the business. Withum is seeking an experienced health claims auditor possessing in-depth knowledge of group health and disability claims procedures, medical/dental terminology, including CPT, ADA, HCPC and ICDA codes, and a thorough understanding of automated health claims systems as well as manual claims payment systems.How You’ll Spend Your Time:Working closely with our clients to ensure that health, dental, prescription and vision claims are being paid in compliance with regulations and plan documentsReviewing client's claims adjudication internal controls policies and proceduresCompleting audit workpapers documenting procedures, findings and conclusions within assigned budgets and deadlinesResponsible for scheduling and oversight of claims team (3-5 at any given time)Review work of team members and present to engagement partner for their final reviewThe Type's of People We Look For Have the Following Qualities:BS DegreeMust be qualified at analyzing and interpreting group health insurance contract provisions and reviewing administrative policies and PPO contractsExperience supervising staff and working within a team environmentMust be familiar with HIPAA and ACA compliance standardsMust have a minimum of 7-10 years of health claims processing experience (internal auditing skills a plus)Good computer skills (Microsoft office preferred), excellent communication skillsAbility to travel2-4 years of managerial experience in health claims processing is a plusWithum will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or because he or she is a protected veteran. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

DirectEmployers