The Contract Management Auditor is Responsible for reviewing, analyzing and resolving discrepancies in claim payments as determined by TruBridge Contract Management software. The Contract Management Auditor works closely with team members and the client to ensure necessary and up to date contract information is provided and works with the TruBridge modeling team to confirm terms are modeled correctly.

Essential Functions:

Proactively researches and identifies claim reimbursement discrepancies and takes the necessary steps to resolve the issue and collect maximum reimbursement from payers for services provided.

Reviews and interprets payer contracts and associated documentation to ensure accurate modeling and works with the Contract Management modeling team to ensure accurate calculations and communicate any known updates or changes needed.

Works with payors and client payor representatives through verbal, online and/or written communication as required by specific payor appeal processes to correct and collect underpayments on claims as well as identifying overpayment refunds due from the client to payors as required.

Manage Contract Management processes for multiple clients.

Maintain tracking system and reporting on appeals and under payment recoupments.

Other duties as required.

Minimum Requirements:

3 Years of health care billing multiple payors.

1 Year of Health care Contract Management Auditing or Comparable Experience

Above average knowledge of healthcare billing processes.

High degree of self-motivation, strong organizational skills.

Ability to positively collaborate and communicate with the team.

Can work independently and has a high degree of critical thinking skills.