Credit Balance Auditor
HMS - New Haven, CT

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HMS is seeking a motivated and qualified individual to fill the position of Provider Auditor in our Credit Balance and Provider Audit unit. The primary responsibility for this position is the identification and recovery of client overpayments made to healthcare providers. This position provides on-site and remote account analysis, as well as analytical and technical support, for our nation-wide auditing practice. The position is based in New Haven, Connecticut and requires up to 25% travel. The selected candidate will be a business professional with enthusiasm and exceptional organizational skills. T he incumbent in this position analyzes the following situations to identify instances of overpayments:

Payment received by more than one payor

Retroactive payments

Double billing/payments

Inaccurate postings

Charges written off in excess of amounts actually billed

Debit contractual adjustments

Reclassifacation of accounts

Provider A/R collection systems modeling net revenue at time of billing

Required Skills

2-4 Years of healthcare billing experience

Bachelor’s degree strongly preferred

Equivalent combination of education and experience

Proficiency in Microsoft Office applications (Word, Excel, PowerPoint, and Access)

Ability to travel 25+%

Strong analytical skills and an ability to overcome obstacles and resolve problems

Ability to function effectively under pressure and deadline oriented project demands as well as manage multiple initiatives

Ability to multi-task, establish priorities, and work independently to meet objectives

Required Experience

Healthcare reimbursement or claim knowledge

Demonstrated understanding of coordination of benefit rules

Familiarity with secondary billing, appeals and contractual adjustments

Previous experience in a physician or hospital business office working with payors

Understanding of healthcare claim billing and collection terminology

HMS - 23 months ago - save job - copy to clipboard - block
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