Audit Processor – Entry Level

Growing Healthcare Receivable Management Company seeks a detail-oriented full-time Audit Processor to support our Auditors and Management Teams.

Summary of Responsibilities:

• Follow up and analysis on hospital patient accounts, including follow up with third-party payors
• Provide administrative support, such as copying and filing in accordance with established procedures and act as a support to the Auditors and Management.

Responsibilities:

• Follow up on appeal status for appeals of Managed Care Medical Necessity Denials; Managed Care DRG Changes; IPRO Medical Necessity Denials, IPRO DRG Changes
• Follow up on status for Inpatient/Outpatient claims/denials.
• Identify and analyze different types of correspondence including medical necessity denials, coding revisions, appeal determinations, approval, requests for additional information, etc.
• Documenting, scanning and attaching correspondence in electronic medical record system.
• Send medical record requests to Medical Records Department for processing.
• Communication- Written and Verbal – with different departments/individuals pertaining to correspondence received.
• Pack appeals from MediSys Health Network Appeals Unit (MHNAU) and Psychiatry to be sent out via certified mail.
• Look up in electronic medical record system and add account number to all correspondence
• Retrieve daily faxes.
• Sort and stamp incoming mail daily
• Other department related tasks as assigned by Management for departmental needs