Hospital Bill Audit Associate

Job Summary

Working remotely on a full-time basis, the Hospital Bill Audit Eligibility and Research Associate will perform pre-audit and post-audit analysis of claims and client contracts to determine eligibility for audits and overpayment calculations.

Key responsibilities:

• Utilize payer claim systems to analyze claims and verify eligibility for audits, including updating payment methodologies and identifying non-covered charges
• Review contracts between clients and providers to ensure payment accuracy and determine overpayment calculations
• Document payment analysis outcomes and approve or reject claims for audit based on thorough research

Required qualifications:

• High School Diploma or GED
• At least 1 year of experience in medical claims processing, billing, collections, or contract analysis
• Understanding of payment methodologies and ability to calculate correct payment amounts for claims
• Familiarity with relevant privacy regulations, such as HIPAA
• Proficient in Microsoft Office Suite, including Word, Excel, and Outlook