Revenue Recovery & Reimbursement Auditor

SCP Health; Lafayette (LA); On-site; USD 28,000 - 39,000; Full time

Benefits offered by this job

Medical, dental, vision

401(k) with company match

Paid time off and holidays

Professional development support

Employee wellness resources

Job summary

SCP Health is seeking a Reimbursement Variance Auditor to conduct retrospective reviews of payments from commercial and government plans. You will identify underpayments, optimize reimbursement, and work with payers to resolve issues while aligning with contract terms and federal/state requirements.

In this role, you will liaise with A/R, Administration, Ops, Systems, and the Underpayments team, using PCM, Salesforce, and payer portals to validate payments and improve cash flow across multiple

Qualifications

• Bachelor’s degree or equivalent; managed care/medical billing/reimbursement experience preferred.
• Experience reviewing reimbursement data and payer contracts.
• Familiarity with healthcare reimbursement regulations and state/federal laws.

Responsibilities

• Review appeals and grievances for accuracy and timeliness.
• Analyze reimbursement data for accuracy, trends, and underpayments.
• Coordinate with payers/plans to resolve payment issues and ensure contract compliance.
• Maintain contract information in PCM, Salesforce, and Crossmap.
• Prepare and present audit findings and SBARs as needed.
• Support arbitration datasets and responses as required.

Skills

Attention to detail

Analytical thinking

Communication skills

Problem solving

Time management

Advanced Excel

Team collaboration

Education

Bachelor's degree or equivalent

Tools

Salesforce

athena IDX PCM

Crossmap

Excel

Job description

SCP Health is seeking a Reimbursement Variance Auditor to conduct retrospective reviews of payments from commercial and government plans. You will identify underpayments, optimize reimbursement, and work with payers to resolve issues while aligning with contract terms and federal/state requirements.

In this role, you will liaise with A/R, Administration, Ops, Systems, and the Underpayments team, using PCM, Salesforce, and payer portals to validate payments and improve cash flow across multiple