Full time
Elevance Health
Indianapolis, IN, USA
Provider Auditor This position will work a hybrid model (remote and office), 1 time per week. The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Provider Auditor conducts on-site reviews of medical charts, medical notes, itemized bills and providers contracts to ensure that a claim is paid in accordance with the contract, provider reimbursement policies, and industry standards. How You Will Make An Impact Selects providers to be reviewed based on historical results of other reviews with providers, network management input and dollar volume of provider. Analyzes data to select claims to be reviewed, conducts reviews using medical charts, medical notes, and provider contracts. Verifies dollar...