Junior Auditor - Braintree, MA at Braintree

Job Description

JUNIOR HEALTHCARE AUDITOR Braintree, MA

Connolly Consulting is a growing and profitable recovery audit firm that serves clients in the retail, healthcare, and commercial industries. Founded in 1979, Connolly recovers $500 million annually in overpayments for over 120 of the worlds largest and best run companies in the United States, Europe and Canada. Connolly Consulting is a healthcare industry leader specializing in providing financial auditing, consulting and overpayment identification services to commercial insurers across the country.

Essential Functions

Responsible for ensuring the overall successful delivery of Connolly audit/consulting services to our healthcare clients.

Assist in the management and operations of an audit, reviewing paid medical claims to determine whether an overpayment exits as it relates to coordination of benefits issues, Medicare Services or Contract Compliance issues.

The development and validation of workflows and communication tools to best enhance audit production, client satisfaction, and quality assurance.

Work with IT support staff to develop and implement technological improvements that will support the audit process.

Assist in achieving financial targets.

Assist in developing the teams strategic audit plan.

Preparing/analyzing reports of audit reviews and performance issues with a focus on continuous quality improvement initiatives.

Identifying and recommending corrective action plans and training of processes or techniques to meet accuracy requirements.

Responds professionally and accurately to all client/provider inquiries within required timelines.

Knowledge, Skills and Abilities

Knowledge of healthcare standard codes (CPT4, ICD-9, HCPCS and Revenue Codes) preferred.

Exposure to commercial insurance reimbursement/payment policies, audit reviews and analysis, and medical terminology.

Independent thinker, logical, strategic, with a high focus and attention to detail.

Effective communication and presentation style written and verbal.

Organizational skills; ability to multitask, set priorities, and meet deadlines.

Ability to creatively solve problems, deal with ambiguity.

Develop and implement policy and procedures, perform root cause analysis and present findings

Proficient in Microsoft programs.

Minimum Qualifications

1 to 3 years of healthcare provider reimbursement experience specific to managed care contracting, medical billing, patient accounting, claims auditing, and/or revenue cycle improvement.

Bachelors Degree strongly preferred

*CB-H*

Job Requirements

 
Country: USA, State: Massachusetts, City: Braintree, Company: Connolly - Healthcare.