If you wish to apply to this role please click ‘Apply Now’. You will then be prompted to create a login, password and profile. Your profile is your online resume with us. Please be sure to upload a Word or PDF copy of your resume. This step allows our recruitment team to easily share your information with our hiring leaders. Once you’ve created your profile, you will not need to do this again to apply to other opportunities within our organization.


Existing Employees Click Here : Internal Career Portal

   
Apply Now
Email A Friend
Requisition Number: 162
City: King of Prussia
State / Province: Pennsylvania
Country: U.S.
Job Title: Associate Healthcare Claims Auditor
Location: King of Prussia/PA
Additional Location:
Job Description:

 

Assist healthcare claims auditors and other team members to provide efficient and thorough healthcare claims auditing services to Truven Helath Analytics clients.

RESPONSIBILITIES:

  • Become proficient in the Truven Health Analytics proprietary data analysis and audit tools to enhance the effectiveness of services and deliverables.
  • Participate in internal and external project kick-off meetings to gain understanding of client’s needs.
  • Translate the client’s healthcare Summary Plan Descriptions and Administrative Services Agreement to our proprietary audit rules engine.
  • Assist claims auditor with selection and preparation of claims sample and supporting documentation for the onsite claim review.
  • Assist claims auditor with onsite claim review in limited areas as specified by the lead auditor
  • Assist claims auditor with preparation of draft and final audit reports for delivery to the client and the claims administrator.
  • Support efforts to grow the revenue and profitability of our claims auditing business.

Qualifications:

  • Bachelor’s Degree in Health Administration, Business Administration, Finance or related field, or equivalent experience.
  • Three to four years experience working for a medical benefits administrator/insurer, Pharmacy Benefit Manager (PBM), or managed care organization in a claims processing role
  • Understanding of healthcare benefit plan design and terminology
  • Strong analytical and problem solving skills.
  • Detail oriented with ability to work on multiple client assignments simultaneously.
  • Excellent computer skills (Microsoft Word, Excel, Outlook).
  • Excellent oral and written communication skills.
  • Ability to work independently and as part of a productive audit team.
  • Willingness to travel up to 25%.

Truven Health Analytics, formerly the Healthcare business of Thomson Reuters, delivers unbiased information, analytic tools, benchmarks and services to the healthcare industry. Hospitals, government agencies, employers, health plans, clinicians, and pharmaceutical companies have relied on our solutions for over 30 years. Truven Health Analytics combines deep clinical, financial and healthcare management expertise with innovative technology platforms and information assets to make healthcare better, collaborating with customers to uncover and realize opportunities for improving quality, efficiency, and outcomes. Truven Health Analytics employs approximately 2,200 people worldwide and has principal offices in Ann Arbor, Chicago and Denver. For more information, please visit http://www.truvenhealth.com/.

We seek talented, qualified employees in all our operations regardless of race, gender, national origin, religion, sexual orientation, disability, age, or any other protected classification under country or local law. Truven Health Analytics is an Equal Employment Opportunity/Affirmative Action Employer.

According to the U.S. Citizenship and Immigration Services (USCIS), the H-1B visa cap has been met for the 2014 fiscal year (October 1, 2013-September 30, 2014).

Position Type: Full-Time
   
Apply Now
Email A Friend