Payment Auditor

Omega Healthcare Solutions•Boca Raton, FL

9d•$20 - $31•Remote

About The Position

The Payment Auditor will be responsible for auditing and identifying incorrectly paid patient accounts based on specific, active contracts with insurance payors. This role involves consistently reviewing, prioritizing, and clearing designated payment variance work queues within the Epic electronic health record system. The auditor will work from financial reporting to target and isolate underpayments, and will log, track, and document all discrepancies and findings within Epic. A key part of the role includes partnering with payor contracting teams and external payors to recover identified underpayments, and communicating collected revenue metrics to management. The Payment Auditor will also serve as an internal resource for complex questions regarding reimbursement, payment terms, and contract structures. Additionally, the role requires extracting, manipulating, and analyzing large datasets to identify systemic contract non-compliance or underpayments. The duties listed are representative, and an individual may perform a subset or all of these functions, as well as other related tasks as assigned.

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.
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.

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.