Harvey, Louisiana
Healthcare Payment Auditor Job Opening in Harvey, Louisiana - Indeed Hire and Margin Recovery Int'l LLC are partnering together to find a Healthcare Payment Auditor to join their team in Harvey, LA. As an Auditor on MRI?s Audit & Recovery team, you'll help build a growing organization, win over hospital, health system, and surgery center clients with superior customer service and service offerings. You?ll be a critical part of the growth of an emerging leader in hospital revenue cycle solutions. You will work alongside MRI team members to execute project plans which enhance the bottom-line profits for our clients.
The Auditor will be responsible for activities focused on assessing/analyzing third party payments, including Managed Care, Medicare, and Medicaid, as it relates to hospital insurance reimbursement. This includes recording and analyzing data, filing appropriate appeals based on findings to ensure additional payment is received in a prompt manner.
Essential Duties and Responsibilities
Leverage data-mining and reimbursement modeling tools to review and identify which are due for additional reimbursement from the payer
Identify and document underpayment root causes by contacting payers via phone and through review of client systems and account documentation
Submit written appeals detailing expected reimbursement and clearly outlining reasons for additional payment, including citation of contract language, policies, and industry standard in a persuasive manner
Through tracking processes, follow-up via telephone and payer websites on appealed accounts for receipt of appeal and payment processing/ resolution of accounts
Ensures productivity and quality standards are met
Ensures that appeals for findings are prepared including appropriate documentation and sent to payer for review timely, accurately while ensuring all HIPAA/compliance and contractual rules and regulations are followed.
Participate in internal client meetings, contributing to a greater understanding of project and initiative progress
Coaches/Partners with other team members
Identify and research new placement concept opportunities
Assist in client reporting
Strict adherence to HIPAA privacy and security rules, including following MRI policy at all times
All other duties as assigned
KNOWLEDGE, SKILLS, ABILITIES
Strong analytical, technical, and creative problem-solving skills.
Demonstrated ability to analyze, understand, and communicate complex issues and trends.
Demonstrated interpersonal skills. Ability to clearly articulate goals and expectations to team members and communicate results to MRI Management.
Customer-service orientation with ability to independently interact with a range of personalities and styles to establish effective relationships internally & externally.
A positive and optimistic attitude that is maintained despite tight deadlines and competing priorities.
Genuine enthusiasm for working for an evolving start-up with the ability to embrace new ideas.
Ability to consistently demonstrate high personal ethics, integrity, prudence, energy, initiative, and self-confidence.
Willingness to work an average of 45 hours per week.
EDUCATION / EXPERIENCE
Bachelor?s degree with concentration preferred
Expertise within the MS Office Suite including Excel, Word, Outlook, and Access preferred
COMPENSATION AND BENEFITS
Competitive salary commensurate on relevant experience
Paid time off and holidays
Paid health and dental
401(k) plan with employer match after one year of service
Job Type: Full-time
Required education:
Bachelor's
Required experience:
Third Party Payment Analysis: 3 years
Healthcare Reimbursement Audit: 3 years
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