Description We are offering a short term contract employment opportunity for a Medical Claims Auditor in El Monte, California, United States. This role is within the Healthcare, Hospitals, and Social Assistance industry. As a Medical Claims Auditor, you will be tasked with reviewing processed claims for accuracy, identifying potential fraud, waste and abuse, and ensuring compliance with various guidelines and regulations. Responsibilities: • Review and audit claim payments for accuracy and consistency ensuring they meet the standards dictated by Department Policies and Procedures. • Identify and track correction of claim adjudication errors. • Generate and use claims adjudication reports to identify claims adjudication errors. • Ensure compliance with the organization’s Policies and as well as County, State, Federal and other regulatory bodies. • Maintain an updated Claims Manual Processing Guide used by the Claims Department. • Contribute to the team effort by accomplishing related results as needed by the Department. • Report daily audits, focus audits, and random audits of claims payments and provider/member calls to the Claims Manager with a stat report. • Maintain required levels of production and quality standards as established by Claims Manager. • Possess detailed knowledge and understanding of claims payments. • Test and audit claims payments for accuracy on pre and post payments. • Release Held Audits claims for accuracy and consistency. Requirements • Proficiency in Claim Adjudication • Familiarity with Claim Denials • Experience in conducting Claims audits • Knowledge in Medical Claims processing • Understanding of Medical Terminology • Proven skills in Auditing • Experience in Claim Administration • Familiarity with CPT Codes • Proficiency in using Facets software • Experience in Health Care Audits, specifically Medicare and Medicaid • Understanding of Health Plan operations • Knowledge of ICD-9 coding system • Experience in processing Insurance Claims • Proficiency in using OnBase software • Proficient in Microsoft Excel • Familiarity with CMS Platform • Knowledge of Medicare processes • Ability to manage and manipulate Spreadsheets Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. Robert Half will consider for employment qualified applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .