Underpayment Auditor
Medassets - Saddle River, NJ

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MedAssetsCompany Overview:MedAssets partners with healthcare providers to improve their financial strength by implementing integrated spend management and revenue cycle solutions that help control cost, improve margins and cash flow, increase regulatory compliance, and optimize operational efficiency. MedAssets serves more than 125 health systems, 3,300 hospitals and 30,000 non-acute care healthcare providers. For more information, visit www.medassets.com. Job Purpose: The Underpayment Recovery auditor position will recover lost revenue for hospitals and physicians related to underpayments. The individual will review accounts identified as underpaid through managed care networks. This person will serve as a liaison with managed care company representatives to address contractual issues related to underpayments, and will be responsible for resolution of the accounts.Essential Duties & Responsibilities: Reviews historical payment information regarding provider dates of service to determineaccuracy of reimbursements. Reviews hospitals managed care contracts to determine appropriate application of rates, provisions and terms. Identifies potential underpayments through comparison of managed care contracts to claim data. Notifies appropriate third party of potential underpayment. Commences recovery of funds through appropriate follow up with said third party. Manages assigned workload of accounts flagged for potential underpayments. Aggregates common infractions across multiple claims and third parties to maximize recoveries. Travel:Travel not required
Minimum Knowledge, Competencies & Qualifications: Two-year degree. Ability to review and comprehend managed care contract language and payment methodology. Familiar with ICD-9, CPT coding, revenue codes, UB and HCFA billing format. Knowledge of/experience working with provider billing. Experience working with customer support/client issue resolution management. Strong analytical acumen. Proficiency with MS Office Strong leadership skills. Excellent oral and written communication skills.

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MedAssets is at the center of improving the quality and effectiveness of the healthcare industry. From establishing best practice value for...