Auditor - Provider Recovery
Rancho Cucamonga, California
What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
Under the direction of the Provider Claims Resolution & Recovery Supervisor, the Provider Recovery Auditor is responsible for the audit and recovery of claims overpayments including COB and third-party liability.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.
- Competitive salary
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Life, short-term, and long-term disability options
- Career advancement opportunities and professional development
- Wellness programs that promote a healthy work-life balance
- Flexible Spending Account – Health Care/Childcare
- CalPERS retirement
- 457(b) option with a contribution match
- Paid life insurance for employees
- Pet care insurance
Education & Requirement
- Minimum of four (4) years of claims processing experience including Medicare and Medi-Cal
- Two (2) years of experience auditing claims in a managed care environment including contract and financial DOFR interpretation
- Experience with MS Office applications
- High School Diploma or GED required
- Bachelor’s degree from an accredited institution preferred
Key Qualifications
- Knowledge of Medi-Cal and CMS guidelines for claim payments
- Strong analytical and problem-solving skills
- Must be able to review cause and impact of problems and recommend realistic solutions both in writing and in meetings
- Proficient in Microsoft Office, including being able to manipulate large data sets in Excel files
- Excellent oral and written communication skills
- Ability to build successful relationships across the organization
Start your journey towards a thriving future with IEHP and apply TODAY!
Pay Range
- $63,897.60 USD Annually - $83,075.20 USD Annually
Working at IEHP is always about helping our members and helping our team members and for me to address anything that they need from me. It’s something that I take pride in every day.
Maynard Mungcal Learning & Development Analyst 2
I love working for IEHP. I really think they not only care about their members, but they also care about their employees … I've been here for eight years, and I just love it!
Mayra Gomez Senior Pharmacy Medication Management Specialist
It’s not just clocking in and clocking out, but being thoughtful and being proud and being an advocate for the work that we do … When people ask me how my day was or how my work is, it’s something that I’m profoundly proud of because I know that I’m making a difference.
Phillip Lo Director of Business Continuity
