Payment Auditor

Omega Healthcare Management Services • Boca Raton, FL

8d • Remote

About The Position

Essential Job Functions 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. The duties listed above are representative of the role, and an individual may be responsible for performing all, or a specific subset, of these functions . Additionally, an individual may be required to perform other related tasks and responsibilities as applicable or assigned to meet operational and client needs.

Requirements

• 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.
• 2 years of Epic experience.
• Proficiency in using Microsoft Office products, including Word, Excel and PowerPoint.
• Proficiency in use of report writing software.
• Able to manipulate and analyze large amounts of data.

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.
• Review, prioritize, and clear designated payment variance work queues within the Epic electronic health record system.
• Target and isolate system-wide or account-level underpayments using financial reporting.
• Log, track, and document all underpayment discrepancies and audit findings within Epic.
• Partner with payor contracting teams and external payors to recover identified underpayments.
• Track, monitor, and communicate total collected revenue metrics to management.
• Answer complex questions relating to reimbursement issues, payment terms, and contract structures.
• Extract, manipulate, and analyze large, complex datasets to identify systemic contract non-compliance or systemic payor underpayments.

What This Job Offers

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