Healthcare Auditor

Job Summary

Developing contract models for analysis, the full-time Healthcare Auditor will identify potential insurance reimbursement issues through extensive reviews of hospital claim data and related documents while working remotely.

Key responsibilities

• Create and update audit plans to outline potential risk areas of hospital-payer contracts
• Review insurance payments and research applicable sources to determine payment accuracy and recommend next steps
• Conduct reviews of zero-balance hospital accounts to identify underpaid inpatient claims

Required qualifications

• High School Diploma or equivalent required
• Minimum of 2 years of experience working with large sets of healthcare data
• Minimum of 2 years of experience with managed care contracts and hospital reimbursement
• Minimum of 1 year of experience with contract modeling
• Basic Excel skills, including knowledge of simple formulas and pivot tables