Auditor ARA/Analyst - Customer Service
Company: Southern California United Food & Commercial W
Location: Cypress
Posted on: January 15, 2026
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Job Description:
Job Description Job Description SUMMARY: The Auditor/ARA Analyst
is responsible for auditing claims for coding accuracy, benefit
payment, customer service calls and compliance with department
policies and procedures. This position is also accountable for
making recommendations to improve quality, workflow processes,
policies and procedures. In addition, the Auditor/ARA Analyst will
support the training and auditing of new/existing Claims department
staff. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.
Other duties may be assigned. Audit all aspects of the claims
adjudication process to include all DOC Types as outlined in the
department audit program. Monitor, listen to, and evaluate calls to
assess customer service expectations, audit interactions for
accuracy, professionalism, and adherence to call scripts. Provide
detailed documentation of all audit findings. Record and maintain a
record of all internal audit results. Collaborate with Claims
leaders to resolve rebuttals on claims errors. Complete second
level claims reviews, in coordination with the Appeals Coordinator.
Coordinate and respond to Medicare Secondary Payer demand notices
from the Department of Treasury and Collection Agencies. Lead or
collaborate with Department Trainer on the update and/or
development of training materials. Maintain current department
knowledge of plan documents, summaries of plan provisions and other
plan materials. Identify and recommend process improvements for
internal workflow, system processes and updates to benefit plans.
Perform other job related duties/special projects as assigned.
Exceptional customer service skills with the ability to build
rapport with Plan participants, team members and other employees of
the Fund Comply with the policies of the Trust Fund, as set forth
in the Employee Handbook. Abide by organizational and HIPAA
guidelines, privacy practices, and confidentiality. Adhere to the
company’s attendance policy. QUALIFICATION REQUIREMENTS : To
perform this job successfully, an individual must be able to
perform each essential duty satisfactorily, including regular and
consistent attendance. The requirements listed below are
representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions. EDUCATION and/or
EXPERIENCE : High School diploma or GED required 3-4 years of
experience as a Medical Claims Adjuster and/or Customer Service
Representative. 1-2 years of experience as a Claims Auditor Able to
utilize MS Office (Excel, Word and Outlook) proficiency required.
OTHER SKILLS and ABILITIES: Dedication to upholding the company's
mission, vision and values. Effective communication (verbal and
written) and interpersonal skills. Cultivate a productive work
environment.
Keywords: Southern California United Food & Commercial W, South Gate , Auditor ARA/Analyst - Customer Service, Customer Service & Call Center , Cypress, California
