Health Claims Auditor
HEALTH CLAIMS AUDITOR
Health Claims Audit Department
Guardian Life of the Caribbean Limited
Job Objective
The Junior Health Claims Auditor performs professional level health claims auditing work. This involves collecting, collating, reviewing and documenting documentation and reports related to RTA and Paper Health Claims; performing substantive audit procedures and other auditing techniques; analyzing trends and other audit findings and providing information to the Senior Health Claims Auditor. He/She works under the supervision of the Senior Health Claims Auditor with considerable latitude for independent judgement. This post involves local and regional travel.
Job Responsibilities
Education
First Degree in Business, Management or Accounting from a recognized tertiary level educational institution.
LOMA 280, 290, ACS 100 and all related parts
Certification as a CIA, ACCA, CPA, or CISA.
Experience
Experience in Industry auditing and accounting and/or 2 - 5 years’ insurance experience in the Insurance Industry in a claims adjudication role.
Personality
The Health Claims Auditor must be hard-working and devoted. He/ She must be honest and must be highly confidential and should possess unquestionable ethics. The Health Claims Auditor must be tactful, well composed and should have good team orientation. The individual must be well organized and very though in order to complete tasks efficiently. He/ She must be very detailed and thorough and must be able to adapt to a very dynamic environment. The Health Claims Auditor must have a very warm and engaging personality and must be able to interact well with others.
N.B. The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities as requested by the Manager from time to time, as needed.