The Claims Auditor is responsible for auditing medical claims for accuracy, completeness, and compliance with payer guidelines and contractual agreements. They will also analyze claims data to identify billing errors and collaborate with teams to resolve discrepancies and improve processes.
Benefits:
401(k)
401(k) matching
Company parties
Dental insurance
Employee discounts
Health insurance
Opportunity for advancement
Paid time off
Parental leave
Savings bank
Training & development
Vision insurance
Wellness resources
About the Role:
MedPOINT Management is looking for a detail-oriented Claims Auditor to join our team in Sherman Oaks, CA. In this critical role, you'll help ensure the accuracy and integrity of claims processing within a dynamic healthcare management environment. If you have a sharp eye for detail and a passion for healthcare operations, we want to hear from you!
Responsibilities:
Audit medical claims for accuracy, completeness, and compliance with payer guidelines and contractual agreements
Review and analyze claims data to identify billing errors, overpayments, and underpayments
Conduct pre- and post-payment audits to ensure proper reimbursement and reduce financial risk
Document audit findings and prepare detailed reports for management review
Collaborate with claims processing and provider relations teams to resolve discrepancies
Monitor claims trends and recommend process improvements to enhance accuracy and efficiency
Ensure compliance with federal, state, and managed care regulations including ICD-10, CPT, and HCPCS coding standards
Requirements:
2+ years of experience in claims auditing, claims processing, or healthcare billing
Strong knowledge of ICD-10, CPT, and HCPCS coding
Familiarity with managed care, IPA, or HMO claims environments preferred
Proficiency in claims management systems and Microsoft Office Suite
Exceptional attention to detail and strong analytical skills
Excellent written and verbal communication skills for reporting and cross-team collaboration
CPC, CCA, or related coding/billing certification is a plus
About Us:
MedPOINT Management is a leading Independent Practice Association (IPA) management company serving the greater Los Angeles area, dedicated to delivering high-quality, coordinated healthcare to patients across Southern California. Providers and patients trust MedPOINT for our commitment to operational excellence and compassionate care coordination. Our team enjoys a collaborative work culture, opportunities for professional growth, and the satisfaction of making a meaningful impact in the healthcare industry.
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