Healthcare Contract Management Auditor

TruBridge; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

A leading company is seeking a Healthcare Contract Management Auditor who will be responsible for analyzing discrepancies in claim payments and working closely with internal teams to ensure accurate contract information. The ideal candidate has strong analytical and investigative skills with experience in healthcare billing processes. This role offers remote work flexibility and a robust benefits package.

Benefits

401(k)

Generous time off allotments

Employer-paid short-term disability insurance

Life insurance

Paid paternity leave

Paid maternity leave

Qualifications

• 3 years of health care billing experience with multiple payors.
• Strong knowledge of health care billing processes.
• 5 years preferred in health care billing with multiple providers.

Responsibilities

• Review and analyze discrepancies in claim payments.
• Research and resolve claim reimbursement discrepancies.
• Maintain tracking systems and reporting on appeals.

Skills

Analytical skills

Investigative skills

Issue resolution

Collaboration

Job description

Join to apply for the Healthcare Contract Management Auditor role at TruBridge

Join to apply for the Healthcare Contract Management Auditor role at TruBridge

Direct message the job poster from TruBridge

Recruiter at TruBridge on behalf of CornerstoneRPO

Job Responsibilities:

The Contract Management Auditor is Responsible for reviewing, analyzing and resolving discrepancies in claim payments as determined by TruBridge Contract Management software. The Contract Management Auditor works closely with team members and the client to ensure necessary and up to date contract information is provided and works with the TruBridge modeling team to confirm terms are modeled correctly.

Essential Functions:

Proactively researches and identifies claim reimbursement discrepancies and takes the necessary steps to resolve the issue and collect maximum reimbursement from payers for services provided.

Reviews and interprets payer contracts and associated documentation to ensure accurate modeling and works with the Contract Management modeling team to ensure accurate calculations and communicate any known updates or changes needed.

Works with payors and client payor representatives through verbal, online and/or written communication as required by specific payor appeal processes to correct and collect underpayments on claims as well as identifying overpayment refunds due from the client to payors as required. Manage Contract Management processes for multiple clients.

Maintain tracking system and reporting on appeals and under payment recoupments.

Other duties as required.

• 3 Years of health care billing multiple payors.
• Strong knowledge of healthcare billing processes.
• Above average investigative and analytical skills
• Skilled in identifying and resolving issues
• High degree of self-motivation
• Ability to positively collaborate and communicate with team members

Preferred Qualifications:

• 5 years of health care billing multiple providers
• Health Care Contract Management Experience

Why join our team?

• Work remotely with a work/life balance approach
• Robust benefits offering, including 401(k)
• Generous time off allotments
• 10 paid holidays annually
• Employer-paid short term disability and life insurance

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Information Technology

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Paid paternity leave

Paid maternity leave

Disability insurance

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