Auditor, Intermediate / Senior Auditor, Advanced

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🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

🔎 Auditor

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CorroHealth

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

CorroHealth is a leading provider of clinically led healthcare analytics and technology-driven solutions, focused on enhancing the financial performance of hospitals and health systems. Their integrated solutions and advanced technologies aim to optimize the entire revenue cycle, offering services such as revenue cycle management, clinical documentation, medical coding, and denials management. With a commitment to improving financial health through intelligent technology and expert guidance, CorroHealth addresses complex payer-provider relationships and supports efficient healthcare operations.

📋 Description

• Develop contract models for analysis and identify potential insurance reimbursement issues through extensive review of hospital claim data and related documentation • Create and update audit plans, identifying risk areas within hospital-payer contracts and methodologies for finding those risks in claims data • Review insurance payments and supporting documentation to determine payment accuracy and identify reimbursement opportunities • Research, analyze, and summarize underpayment issues, financial impacts, reimbursement trends, and recommended actions • Identify contractual and clinical reimbursement risk areas across commercial and government payors • Develop specifications and procedures to identify and troubleshoot contractual, coding, and administrative underpayment risks • Conduct reviews of zero-balance hospital accounts to identify underpaid inpatient and outpatient claims • Model reimbursement methodologies and create or maintain pricing documents used to calculate expected payments • Collaborate with data analysts and project teams to develop, validate, and enhance pricing models and audit methodologies • Leverage technical tools and automation opportunities to improve audit efficiency and consistency • Present findings, processes, methodologies, and recommendations through clear documentation and reporting • Recommend improvements to internal processes, audit methodologies, and client contract administration processes • Research emerging reimbursement trends, regulatory changes, and payer practices and communicate findings to internal stakeholders • Senior Auditors may independently lead complex audit projects, identify new audit opportunities, serve as subject matter experts, mentor and train auditors, develop training materials, and provide technical guidance and quality review

🎯 Requirements

• High School Diploma or equivalent required • Bachelor's degree in a related field or equivalent experience preferred • Auditor (intermediate): Minimum 3 years of experience working with large healthcare data sets • Auditor (intermediate): Minimum 2 years of experience in research and analysis • Auditor (intermediate): Minimum 2 years of experience with managed care contracts and hospital reimbursement • Auditor (intermediate): Minimum 2 years of experience working with inpatient claims • Auditor (intermediate): Minimum 1 year of experience working with Medicare, Medicaid, and/or outpatient facility claims • Auditor (intermediate): Minimum 1 year of experience with contract modeling • Senior Auditor (Advanced): Minimum 5 years of experience working with large healthcare data sets • Senior Auditor (Advanced): Minimum 5 years of experience in research and analysis • Senior Auditor (Advanced): Minimum 3 years of experience with managed care contracts and hospital reimbursement • Senior Auditor (Advanced): Minimum 3 years of experience working with inpatient and outpatient claims • Senior Auditor (Advanced): Minimum 2 years of experience with contract modeling • Ability to translate complex contract language and healthcare data into actionable insights • Ability to work independently to solve problems and recommend technical solutions • Intermediate Excel skills, including complex formulas, functions, and pivot tables; senior level requires intermediate to advanced Excel, including lookups • Basic knowledge of Access and SQL preferred • Senior-level ability to lead complex audits and reimbursement investigations • Senior-level ability to mentor, train, and develop staff • Strong organizational, analytical, written, and verbal communication skills • Strong attention to detail • Ability to perform work at a computer terminal for 6–8 hours a day • Infrequent ability to lift and move material weighing up to 20 lbs.

🏖️ Benefits

• Quality of life with a remote predictable, full-time schedule • Competitive compensation commensurate to experience • Medical, Dental, Vision coverage and more • Long-term disability insurance, and life insurance • Ample parental leave • 401K with company match • Certification and Tuition Reimbursement • Holidays, paid time off