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Clinical Claims Auditing Manager

ed Long Term Care facility seeking a Clinical Claims Auditing Manager. This manager will be in charge of performing audit procedures including identifying and defining issues, developing criteria and reviewing and analyzing specific system authorizations. Entire work environment is paperless so applicant must have knowledge of multiple Patient Health Information (PHI) databases. Some of the systems may include but are not limited too CareEnhance Clinical Management Software (CCMS), Sungard Macess Service Module (electronic archiving), RightFax, VoIP, Virtual Work Platforms (VPN), Adobe Acrobat and MS Office.   Qualifications: High School diploma or GED (Associates degree preferred) Experience using Microsoft Office, Electronic Medical Records(EMR), ICD-10 codes, medical abbreviations and medications Experience reviewing medical records, processing claims and case management in a clinical practice or managed care organization Ability to multitask and use multiple databases at one time   Bilingual in any of the following languages is a huge plus: - Russian - Chinese (Cantonese/Mandarin) - Shanghainese -Fukienese   Please send resume for immediate consideration.

La Habra, California