Payment Auditor

Omega Healthcare Management Services • Boca Raton, FL

5d • Remote

About The Position

Under limited supervision, the Payment Auditor is responsible for identifying insurance claims paid incorrectly to maximize revenue recovery. The Payment Auditor acts as a vital cross-functional liaison, partnering with payor contracting teams and external payors to recover revenue, monitor recovery metrics, and provide subject matter expertise on complex reimbursement issues.

Requirements

• Must be adept at multi-tasking and prioritizing a variety of tasks, often changing assignments on short notice in a fast-paced environment.
• Strong analytical, critical thinking, and problem-solving skills to successfully manage individual KRAs and meet production metrics.
• Excellent verbal, listening, and written communication skills to build trust, maintain credibility, and remain composed during stressful situations.
• Perform data entry with accuracy while safeguarding corporate and client assets, proactively reporting any security compromises.
• Skill in operating a computer and learning multiple software or hardware systems concurrently within an average workday.
• High school diploma, or equivalent.
• Minimum 3 years of healthcare experience or a comparable combination of education and experience.
• Ability to manipulate and analyze large amounts of data.
• Strong foundational knowledge of medical billing practices and medical terminology.

Nice To Haves

• Direct experience handling payment variances or contract modeling within Epic.
• Equivalent experience in managed care, health care finance, or healthcare information technology.

Responsibilities

• Audit and identify patient accounts paid incorrectly based on specific, active contracts with insurance payors.
• Consistently review, prioritize, and clear designated payment variance work queues within the Epic electronic health record system.
• Work from regular, high-volume financial reporting to actively target and isolate system-wide or account-level underpayments.
• Log, track, and thoroughly document all underpayment discrepancies and audit findings within Epic.
• Partner with payor contracting teams and external payors to recover identified underpayments.
• Track monitor and regularly communicate total collected revenue metrics to management.
• Act as an internal resource to answer complex questions relating to reimbursement issues, payment terms, and contract structures for diverse patient populations.
• Extract, manipulate, and analyze large, complex datasets to identify systemic contract non-compliance or systemic payor underpayments.

Benefits

• Equal Employment Opportunity employer.
• Makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED