Our Client, a Health Insurance company, is looking for a Healthcare Claims Auditor II for their Detroit, MI location. Responsibilities:


+ Engagement Description – Supports audit by retrieving, validating, and compiling documentation from claims systems to meet quality and deadline requirements.

+ Partners with internal teams to respond to audit inquiries, resolve gaps, and ensure accurate submissions.

+ Tracks and manages audit inquiries and deliverables, proactively identifying risks and ensuring timely completion.

+ Conducts detailed claim reviews to validate audit samples and investigate errors.

+ Determines appropriate documentation to support claim payments.

+ Monitors implementation of corrective actions to ensure resolution.

+ Communicates findings clearly, both verbally and in writing, and prepares and refines audit responses to ensure accuracy and clarity.

Requirements:

+ To...