Senior Internal Auditor role at TD SYNNEX ensuring compliance and improving operational controls. Engage with teams to enhance financial integrity and audit practices within the organization.
About the role
- Claims Auditor role responsible for auditing high dollar claims within healthcare. Flexible remote work with occasional in-person training sessions required.
Responsibilities
- Responsible for pre and post payment and adjudication audits of high dollar claims
- Ensures claim payment accuracy by verifying eligibility, pre-authorization, and medical necessity
- Contacts others to obtain necessary information
- Completes and maintains detailed documentation of audits
- Provides feedback on processing errors and identifies quality improvement opportunities
- Handles specialized claims independently (Claims Auditor II)
- Serves as subject matter expert and mentor (Claims Auditor Senior)
Requirements
- Claims Auditor I: HS diploma or GED and a minimum of 3 years of claims processing experience
- Claims Auditor II: HS diploma or GED and a minimum of 5 years of claims processing experience including a minimum of 1 year related experience in a quality audit capacity
- Claims Auditor Senior: HS diploma or GED and a minimum of 4 years related experience in a quality audit capacity
- Stop loss claims experience highly preferred
- Working knowledge of insurance industry and medical terminology
- Strong research and problem solving skills
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
- Paid Time Off
- Medical, dental, vision benefits
- Short and long term disability benefits
- Wellness programs
- Financial education resources
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