Job Overview WTW, a leading global advisory, broking, and solutions company, is seeking a skilled Medical Claim Lead Auditor to join our remote team. In this pivotal role, you will lead comprehensive audits of medical claims, ensuring adherence to regulatory standards, payer guidelines, and internal policies. This position offers the flexibility of 100% remote work, allowing you to contribute to healthcare claims integrity from anywhere while advancing your career in a dynamic, innovative environment. Key Responsibilities As the Medical Claim Lead Auditor, you will spearhead end-to-end audit processes, reviewing complex medical claims for accuracy, completeness, and compliance with HIPAA, CMS, and other relevant regulations. You will mentor and supervise a team of auditors, assign workloads, conduct quality assurance reviews, and prepare detailed audit reports with actionable recommendations. Additionally, you will collaborate with cross-functional teams including claims processors, providers, and legal experts to resolve discrepancies, recover overpayments, and optimize claims workflows. Stay abreast of evolving industry standards and implement best practices to mitigate risks and enhance operational efficiency. Required Qualifications Candidates must hold a Bachelor's degree in Healthcare Administration, Nursing, Finance, or a related field, coupled with at least 7 years of progressive experience in medical claims auditing or coding. Certification as a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or equivalent is required. Proven leadership experience in managing audit teams and a strong understanding of medical terminology, ICD-10, CPT, and HCPCS coding systems are essential. Skills Exceptional analytical and problem-solving abilities are crucial, along with proficiency in audit software such as FACETS, Epic, or ClaimsXten. Strong communication skills, both written and verbal, are necessary for stakeholder interactions and report generation. You should demonstrate expertise in data analysis tools like Excel, SQL, and Tableau, with a keen eye for detail and the capacity to handle high-volume workloads under tight deadlines. Leadership qualities, including team motivation and conflict resolution, will set you apart. Company Info WTW (Willis Towers Watson) is a global powerhouse with over 46,000 associates across 140 countries, delivering innovative solutions in risk management, insurance brokerage, and health, wealth, and career consulting. Renowned for our client-centric approach, we empower businesses and individuals to navigate complex challenges in an ever-changing world. Benefits We offer a competitive compensation package, including comprehensive health, dental, and vision insurance, 401(k) matching, generous paid time off, and parental leave. Enjoy flexible remote work options, professional development stipends, and wellness programs to support your work-life balance. Growth Opportunities At WTW, your career trajectory is limitless. Access tailored leadership development programs, mentorship from industry experts, and opportunities for global mobility. Advance to senior audit management or specialized consulting roles as you drive impactful change in healthcare auditing.