Reimbursement Variance Auditor Position Available In Lafayette, Louisiana

Reimbursement Variance Auditor 3.3 3.3 out of 5 stars Lafayette, LA At SCP Health, what you do matters As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care. Why you will love working here: Strong track record of providing excellent work/life balance. Comprehensive benefits package and competitive compensation. – Commitment to fostering an inclusive culture of belonging and empowerment through our core values – collaboration, courage, agility, and respect.

Responsibilities :

Provide expertise or general support in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances Perform third party contract reimbursement and utilization review for those policies and procedures related to the definition, identification and collection of denied or incorrect payments and management of denials of payment for the business office Reviews reimbursement data for accuracy of payments, adjustments and contract procedures Verify and compare reimbursement rates with existing fee schedules on file for accuracy Provides input and recommends improvement to existing fee schedules in an effort to maximize reimbursement, improve billing efficiency and reduce accounts receivable aging Provides guidance and/or assists billing representatives in the accounts receivable follow-up process. Analyze and identify trends for appeals and grievances Where appropriate, aggregates underpayment trends for expedited processing Provides feedback to manager regarding false positive and true underpayment issues Maintain appropriate fee schedules and request system setup Maintains a high level of accuracy of follow-up while maintaining thorough and concise notes documenting communication with managed care companies Utilizes payer portal websites, client patient account systems, internal technology to continually validate activity, payment accuracy, and account status Communicate with appropriate parties issues, implications and decisions Liaison to billing companies, payers and other necessary parties; responsible for ensuring the correction of discoveries Maintain thorough knowledge of reimbursement regulations related to assigned region Provide feedback to Revenue Cycle related to improvement opportunities and appeal campaigns Ensures that company policies and procedures are current and accurately reflect processes in order to comply with regulatory requirements. Authority on impending reimbursement changes and current trends Identifies system or procedural problems creating third party claim rejections. Formulates and implements plans for minimizing or eliminating these rejections Assists in the performance contract reviews of third party payer agreements What we are looking for: Bachelor’s degree or equivalent work experience 1-3 years previous Managed Care, medical billing, and/or healthcare reimbursement experience Ability to work and independently, displaying a keen eye for attention to detail, and providing accurate status of progress, issues, and risks on all projects. Ability to exercise considerable individual judgment and initiative, and to rely on experience and judgment to plan and accomplish goals. Ability to work under moderate stress and pressure while maintaining a positive, professional manner both in person and via phone, e-mail, business letter, or fax. Ability to produce quality and timely results while handling multiple projects, exhibiting good organizational and time management skills. A wide degree of creativity and latitude is expected. Must work well with others, exhibiting professional courtesy and excellent customer relation skills. Ability to communicate clearly and effectively, both verbally and in writing with all levels of professionals, including executives. Ability to effectively problem solve, and to collect and analyze complex data. Ability to coordinate projects with diverse groups and individuals. Ability to prepare and explain effective reports. Willingness to adhere to productivity goals and departmental guidelines. Advanced understanding of healthcare reimbursement, and of state and federal insurance laws. Proficiency in Microsoft Office products, with advanced Excel skills. This position is eligible for our corporate benefits, please click this link for the details: https://myscpbenefits.com/ SCP Health and its affiliated companies require all applicants for a non-clinical position to be vaccinated against

COVID-19

as a condition of employment, except where prohibited by state or local law. To demonstrate compliance with SCP Health’s vaccination policy, proof of

COVID-19

vaccination status will be requested upon a conditional offer of employment. SCP Health will consider religious and/or medical/disability accommodation and other legally required exemption requests as required by applicable law. To learn more about SCP Health, please visit: www.scphealth.com SCP Health is an Equal Opportunity Employer. To learn more about SCP Health, please visit: www.scp-health.

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