Payment Integrity Auditor I/II/III
$62.4k/y-$142.3k/y
Lifetime Benefit Solutions, Inc.a day ago
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OnsiteFull-timeEntry
Summary
Lifetime Benefit Solutions, Inc. is seeking a Payment Integrity Auditor I/II/III to join their team in Johnson City, NY. The role involves investigating and remediating claim overpayments and ensuring claims payment integrity across all lines of business.
About the Role
As a Payment Integrity Auditor, you will be responsible for conducting thorough investigations of potential claim payment integrity issues, utilizing various systems and data applications. You will analyze data to extract trends and insights, collaborate with stakeholders for root cause analysis, and ensure compliance with regulatory standards. The position requires adherence to coding guidelines and the ability to interpret complex documents related to provider contracts and billing policies.
About You
Required:
- Professional Registered Nurse (RN) with current NYS license or other allied health professional with current NYS license and a minimum of three (3) years of experience in claims auditing, quality assurance, or recovery auditing in a healthcare setting.
- Basic knowledge of medical claims billing/payment systems, provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology.
Preferred:
- Certified Professional Coder (CPC) or other related certification.
- Minimum of two (2) years’ experience in the healthcare industry, particularly in Claim Review, Utilization Management, or Audit.
Benefits
- Competitive salary range from $62,400 to $142,322 depending on level and experience.
- Participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.
Lifetime Benefit Solutions, Inc.
As a national ancillary benefits provider, we offer a diverse suite of products and services to help employers of all sizes round out their traditional benefits packages. However, our business is more than just the products we offer. Ultimately, we’re in the business of getting our clients closer to their goals – something we’ve committed to since our inception in 1974. Whether that’s offering benefits that attract and retain the best talent or simply allowing more time for our clients to focus on their customers, we provide customizable options that put clients and their employees on a path to certainty and success with costs that work for everyone, and personal, dedicated service that works harder.
Johnson City, NY