Medical Bill Audit Coordinator

Identifies and manages existing and emerging risks that stem from business activities and the job role. Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled. Follows written risk and compliance policies, standards, and procedures for business activities. Identifies training needs, facilitates and coordinates provision of formal MBA-related training, and assists with providing formal and informal training, as needed, to include coordinating with the Injury Adjusters and management as appropriate. Based on feedback and review of the process, identifies efficiencies to improve the experience for the member and the employee while remaining compliant with state regulations. Reviews medical bill audit activity reports, identifies necessary actions or issues relative to the report, and facilitates completion of identified actions based on the service level objective (SLO). Assists management and/or member relations with responding to complaint letters regarding payments by Adjusters based on medical bill audit recommendations from Departments of Insurance, Attorneys, members/insured's, and/or providers. Maintains day-to-day currency of the user web access list and communicates daily to MBA Supplier with access changes for users.