Reimbursement Audit Specialist

UofL Health; Louisville (KY); Sur place; USD 38 000 - 52 000; Plein temps

Résumé du poste

UofL Health in Louisville, KY seeks a billing follow-up specialist to review paid insurance claims, analyze payer trends, and ensure reimbursement aligns with contracts. You will interact with payers, physicians, and patients to resolve underpayments and ensure timely cash flow.

Qualifications include a high school diploma or GED and 2–3 years in billing or payor follow-up; proficiency with Excel, Word, and Outlook is preferred.

Qualifications

• High School Diploma or GED required.
• 2–3 years of billing, insurance follow-up or insurance payor experience.
• Experience with ICD-10, revenue codes, CPT-4 and HCPCS preferred.
• Proficiency with MS Excel, Word and Outlook.

Responsabilités

• Primarily responsible for the review and follow up on paid insurance claims (including $0.00 pay) and payor recoupments to determine if reimbursement is accurate.
• Provide root cause analysis and reporting of revenue opportunities to ensure appropriate reimbursement.
• Perform research of paid claims for follow up with payer and analyze payer trends.
• Review claim remittances to determine reimbursement rates and methodologies used by the payer.
• Identify underpayment opportunities and report findings to leadership.
• Audit accounts, payment postings, and contractuals to confirm balance accuracy.
• Communicate payment discrepancies to payer representatives via email, phone, or meetings.

Connaissances

Claim research

Payer follow-up

Payer trends analysis

Remittance review

Excel

Word

Outlook

Communication

Detail oriented

Formation

High School Diploma or GED

Description du poste

UofL Health in Louisville, KY seeks a billing follow-up specialist to review paid insurance claims, analyze payer trends, and ensure reimbursement aligns with contracts. You will interact with payers, physicians, and patients to resolve underpayments and ensure timely cash flow.

Qualifications include a high school diploma or GED and 2–3 years in billing or payor follow-up; proficiency with Excel, Word, and Outlook is preferred.