Healthcare Auditor, Zero Balance

Seeking skilled Healthcare Auditors with expertise in Zero Balance accounts, the full-time remote positions will manage contract models for analysis, identify insurance reimbursement issues, and contribute to quality control and improvement recommendations. Key responsibilities Create and update audit plans to identify risk areas within hospital-payer contracts Review insurance payments and documentation to determine payment accuracy and identify reimbursement opportunities Research and analyze underpayment issues and reimbursement trends to provide actionable recommendations Required qualifications High School Diploma or equivalent required; Bachelor's degree in a related field preferred Minimum 3 years of experience with large healthcare data sets for intermediate auditors; 5 years for senior auditors Experience in research and analysis, with at least 2 years for intermediate and 5 years for senior auditors Proficiency in managed care contracts and hospital reimbursement for both levels of auditors Intermediate to advanced Excel skills, including complex formulas and functions