Healthcare Auditor, Zero Balance

Job Summary

Seeking skilled Healthcare Auditors with expertise in Zero Balance accounts, the full-time remote positions will manage contract models for analysis, identify insurance reimbursement issues, and contribute to quality control and improvement recommendations.

Key responsibilities

• Create and update audit plans to identify risk areas within hospital-payer contracts
• Review insurance payments and documentation to determine payment accuracy and identify reimbursement opportunities
• Research and analyze underpayment issues and reimbursement trends to provide actionable recommendations

Required qualifications

• High School Diploma or equivalent required; Bachelor's degree in a related field preferred
• Minimum 3 years of experience with large healthcare data sets for intermediate auditors; 5 years for senior auditors
• Experience in research and analysis, with at least 2 years for intermediate and 5 years for senior auditors
• Proficiency in managed care contracts and hospital reimbursement for both levels of auditors
• Intermediate to advanced Excel skills, including complex formulas and functions