Payment Auditor

Omega Healthcare Solutions•Boca Raton, FL

6d•$22 - $32•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.
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.
Perform data entry with accuracy while safeguarding corporate and client assets, proactively reporting any security compromises.