Job Description

Responsibilities: · Manage assigned underpaid accounts for clinical or contract compliance validation. · Be the expert when communicating findings to payers or clients. · Pre-empt quality data issues and continuously bring improvement to your analyst. · Maintain an A/R of no more than 120 days. Exceptions will be approved by management. · A key responsibility of the role is accuracy, thus the ability to stay focused during audits is essential. · Conduct root cause analysis of underpayments, i.e., contract compliance, coding, and clinical denials performance issues on an on-going basis with follow-up and implementation of results. · Participate in quality improvement programs, providing reports and recommendations to management. · Provide educational support through training when required. · The role will require a high degree of confidence and experience using MS excel. General Skills & Expectations · Demonstrate verbal, written and listening skills, with the ability to provide expertise at all levels of the business. · Time management and organizational skills are essential. · Ability to work in an agile environment. · Have strong research skills, with the ability to read and understand complex Managed Care contracts, and to apply those to their audit review process. · The ability to collaborate both internally and externally with payers is essential. · Flexibility to respond and react to changing priorities quickly and efficiently. · Desire to question and improve existing processes and the ability to adapt to change. · Team oriented with a high degree of initiative. · Highly organized with attention to detail and a commitment to quality Technical Skills & Expectations · Strong MS Excel. · Computer experience. · Working knowledge of SharePoint and Adobe an advantage. · Experience in Medical or Hospital billing an advantage. · Experience with data analysis to support decision making an advantage.