Location: Knoxville,TN, USA
Position Summary:
Managed Care Auditor is responsible for identifying contracted payer underpayments, interpreting Managed Care contracts, and breaches of contract terms. Mointors Managed Care software to ensure maximum contract compliance and to increase revenue by identifying and collecting underpayments from third party payers.
Position Qualification:
One (1) to three (3) years' work experience with identifying contracted payer underpayment and breeches of contract terms. Basic knowledge of health insurnace and payer medical billing procedures. Ability to read, analyze, and interpret Managed Care contracts (experience is a plus) and financial reports. Ability to write correspondence and to respond to common inquiries or complaints. Ability to work with mathematical concepts such as fractions, percentages, and proportions to practical situations. Ability to define problems, collect data, establish facts, and draw valid conclusions. Working knowledge of Microsoft Office Products, specificall Microsoft Excel functions.
Associates degree (AA) or equivalent from two year college or technical school or equivalent combination of education and experience.