Post Audit - Audit Coordinator I

The Audit Coordinator I supports all post audit functions by ensuring accuracy of audit invoices, itemized bills, and audit fees.  The Audit Coordinator I is responsible for handling calls to and from providers, sending letters to the provider, moving the audits through the audit workflow system (EXL mine) generating and submitting finding files and invoices to the clients.

Responsibilities:

• Perform quality review of client letters, ensuring accuracy of format, spelling and grammar.
• Generating and submitting Finding Files to the client timely and accurately.
• Ensure completed audits are invoice timely and accurately.
• Ensure that all invoicing for medical records, itemized bills and audit fees are handled and processed timely and accurately.
• Prepare reports and any ad hoc requests from Manager.
• Manage group emails.
• Provider collections
• Work with internal departments to resolve invoicing and collection issues.
• Responds to accounting or billing inquiries from providers.
• Serve as a liaison for internal and external clients, including screening phone calls, facilitating client communications to the appropriate client leader and following up with clients, when appropriate.
• Become familiar with client reports and internal reports and assist in their preparation.
• Interact with internal staff and client to re-price audits with validation/audit findings.
• Participate in external operational conference calls with the client (where applicable).
• Ensure all audit issues are documented in the applicable audit program Audit System.
• Escalate issues to management and handle for Follow Up action as needed.
• Provide back-up assistance to other Audit Coordinators as needed.
• Provide back-up scanning assistance to correspondence emailing as needed.
• Comply with HIPAA and other regulations regarding confidentiality of information.
• Other duties as assigned to support the audit process and/or company-wide programs.

Required:

• High School Diploma - Associate degree or relevant certification is a plus
• Solid knowledge of Microsoft Office necessary, especially Excel, Word, and Outlook
• 1 years’ minimum experience working as a Claims Analyst or Claims Auditor in a managed care setting (hospital, health plan or physician office)
• Highly organized, detail oriented and solid problem-solving skills
• Able to make recommendations to improve and streamline processes to make more efficient
• Ability to positively and comfortably handle and prioritize multiple tasks in a fast-paced environment with focused attention to detail
• High level of integrity and confidentiality
• Possesses time management skills; exhibits solid ability to prioritize work and perform multi-tasks.
• Basic knowledge of medical claims
• Prior coding or medical claims experience or training
• Strong written and verbal communication skills

What We Offer:

• EXL Health offers an exciting, fast paced and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.
• From your very first day, you get an opportunity to work closely with highly experienced, world class Healthcare consultants.
• You can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills - key aspects for personal and professional growth.
• We provide guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level professional as advisors.
• Sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond.