Healthcare Audit Analyst (Hybrid)

Purpose of Position

Develops systems and procedures for all government audits, gathers, compiles, organizes and documents relevant audit information. Analyzes, consolidates and interprets audit data. Presents audit findings and all other relevant information to Senior Management, and/or the Audit Committee on an as needed basis.

Responsibilities

• Analyzes, consolidates and interprets audit data.
• Presents audit findings and all other relevant information to Senior Management, and/or the Audit Committee on an as needed basis.
• Delegation of assignments relating to the appeals process to appeal representatives and technical staff.
• Ensures compliance with all corporate standards and audit regulations as well as all CMS and commercial requirements.
• Communicates with/educates external entities including the Centers for Medicare and Medicaid Services, Office of Inspector General, commercial payers, appellants and their authorized representatives.
• Identifies opportunities, using Medicare policies and procedures, claims processing procedures and related data processing systems, to improve overall performance.
• Collaborates with external business partners to recommend, coordinate and initiate improvements to the process to achieve efficiency, cost reduction, productivity, and quality gains.
• Utilizes audit tools and proprietary reports, tools and systems required to perform duties.
• Coordinates provider education activities.
• Provides feedback to management on the status of audits in their section to ensure the department contributes toward the department meeting and exceeding all performance standards.
• Challenges current working practices; identifies process improvement opportunities and presents recommendations and solutions to management.

Requirements

Associate’s or bachelor’s degree in Business or related field, or a combination of education and work experience; One (1) to three (3) years of progressively more responsible healthcare experience. Experience with hospital information systems preferred. Excellent interpersonal, problem solving, and critical thinking skills are required. Excellent PC skills with a strong emphasis on the Outlook suite of products are required. Excellent verbal and written communication skills are required. Prior experience with analysis of government audits are a plus.

Qualifications

Associate’s or bachelor’s degree in Business or related field, or a combination of education and work experience; One (1) to three (3) years of progressively more responsible healthcare experience. Experience with hospital information systems preferred. Excellent interpersonal, problem solving, and critical thinking skills are required. Excellent PC skills with a strong emphasis on the Outlook suite of products are required. Excellent verbal and written communication skills are required. Prior experience with analysis of government audits are a plus.

Skills

Excellent interpersonal, problem solving, and critical thinking skills. Excellent PC skills with a strong emphasis on the Outlook suite of products. Excellent verbal and written communication skills. Prior experience with analysis of government audits.

Benefits

N/A

Pay

Unassigned

Schedule

Full-Time, Monday-Friday, Occasional Evenings, Weekends, & Holidays.