Payment Variance Auditor I

About the role

Underpayment review work that feeds a recovery team: screening potential variances, checking them against contract terms and payor policies, and passing clean findings on for pursuit.

At a glance

What you will do

• Review historical payment data in high-volume reports to check reimbursement accuracy
• Compare managed care contract rates and terms against what was actually paid
• Investigate payor policies to confirm whether a variance is real
• Screen out false positives before findings go to the audit team
• Report underpayment trends to management for collection
• Verify benefits and eligibility to filter out denials and plan issues

What they look for

• High school diploma or GED
• One to two years working with managed care reimbursement and contracts
• Familiarity with ICD-9 and ICD-10, CPT codes, revenue codes, and UB and 1500 claim formats
• Strong analytical skills and comfort with MS Office
• Able to work independently and communicate well in writing and speech