United States onlyJob 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.
Minimum Requirements:
- 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
- Paid Parental Leave
