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Portland Metro Area, Oregon

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Reimbursement Audit Specialist
JOB SUMMARYThe Reimbursement Audit Specialist prepares and monitors reimbursement schedules with hospitals, physicians and ancillary providers based upon the companies' relationship, volume and market sensitivity. Performs audits and analyzes provider contracts to identify underpayment and/or potential overpayment opportunities. Coordinates corrective action plans to ensure compliance and/or improvement of performance.ESSENTIAL FUNCTIONS OF THE ROLEDevelops reimbursement models for hospitals, physicians and ancillary providers based upon financial and actuarials projections. Performs financial analysis to access actual costs prior to contract renegotiations and analyzes provider contracts to identify underpayment and/or potential overpayment oppo


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