Medical Claims Specialist Salary in the United States

Demanded Skills for the Role:

• Confidentiality (Mentioned in 6.45% Job Postings): The process of and obligation to apply and enforce rules and practices that ensure that specific types of information are accessible only to those authorized to use it.
• Claim Reviews (Mentioned in 3.23% Job Postings): A claims review is the process in which the underwriter reviews a claim to assure that it meets a set of standards.
• Internal Audit (Mentioned in 3.23% Job Postings): Internal auditing is an independent, objective assurance and consulting activity designed to add value to and improve an organization's operations. It helps an organization accomplish its objectives by bringing a systematic, disciplined approach to evaluate and improve the effectiveness of risk management, control and governance processes. Internal auditing achieves this by providing insight and recommendations based on analyses and assessments of data and business processes. With commitment to integrity and accountability, internal auditing provides value to governing bodies and senior management as an objective source of independent advice. Professionals called internal auditors are employed by organizations to perform the internal auditing activity. The scope of internal auditing within an organization is broad and may involve topics such as an organization's governance, risk management and management controls over: efficiency/effectiveness of operations (including safeguarding of assets), the reliability of financial and management reporting, and compliance with laws and regulations. Internal auditing may also involve conducting proactive fraud audits to identify potentially fraudulent acts; participating in fraud investigations under the direction of fraud investigation professionals, and conducting post investigation fraud audits to identify control breakdowns and establish financial loss.