Demant

Auditor, Claims & Call Center

Department AudioNet America
Job Locations US-FL-Jacksonville
Job ID
2022-16066

Overview

Demant is a leading international hearing healthcare company that develops, produces, and sells hearing solutions, accessories, diagnostic instruments, and personal communication. The group operates in a global market with companies in more than 30 countries, employees exceeding 14,000, and revenues of well over 2 billion USD. Demant has a strong presence in the US market and is looking for outstanding passionate talent committed to the goals and mission of the company.

 

Under the direction of the VP Operations, the Auditor, Claims & Call Center will be focused on analyzing claims and call center data to identify processing errors.  Working on audits for data integrity and partnering internally on reporting and strategy, this role will help advance our claims and call center process, shaping a successful journey for our customers.

Responsibilities

  • Analyze data to assess the accuracy of claims payments and call center data
  • Identify trends and anomalies within claims/call center data and perform root cause analysis
  • Review plan documents, service agreements, and provider contracts
  • Communicate audit results in a structured report format within required timelines
  • Adhere to corporate standards for performance metrics, data integrity, and reporting format to ensure high quality, meaningful output and the strictest confidentiality at all times
  • Facilitate the correction of claim/call center errors
  • Understand the types of contracting arrangements that need to be configured in the appropriate applications to support the accurate and timely payment of claims
  • Identify non-routine audit procedures that should be performed
  • Interact with multiple business partners as required
  • Strong contributor to the team, sharing ideas with the team and across the claims and customer service discipline
  • Perform other duties as necessary or assigned by Supervisor

Qualifications

Requirements and Must Have Criteria

  • 5+ years of experience in healthcare environment with understanding of claims adjudication
  • Ability to dissect data elements, identify root causes/trends, and quantify the “cost of non-compliance”
  • Ability to provide consultation and expert advice to management
  • Ability to manage resources in a matrix environment, communicating and influencing effectively at all levels of the organization
  • Ability to excel independently and in a team environment
  • Excellent time management and organizational skills

Education

Bachelor’s degree in healthcare or business-related field and/or related work experience

 

The Company is an Equal Opportunity / Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

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