Salish Stories Group

In today’s inflationary environment, auditing healthcare claims has emerged as a critical concern for large employers with self-funded medical plans. The COVID-19 pandemic significantly amplified the need for medical claim auditors, as the unprecedented expenditures during the pandemic years necessitated thorough reviews of claims. Employers are more aware than ever of the rising instances of overcharges for standard medical services and shifts in utilization rates. This heightened scrutiny of claim auditing reflects the importance of accurate financial management during times of economic uncertainty.

Fortunately, audit firms have adopted advanced methods, utilizing both electronic systems and human expertise to conduct a detailed review of claims. Unlike in the past, when random sampling was the norm, these firms now conduct 100 percent reviews. This approach identifies a greater number of errors and facilitates the detection of opportunities for system enhancements that can prevent future discrepancies, thereby enhancing operational efficiency. In the current…

Obtaining qualifications like level 6 nvq construction management helps professionals grow in their roles. The College of Contract Management provides a course that blends learning with workplace tasks. The course uses real job experience as part of the assessment. Many have benefitted and successfully secured leadership positions.