Come join our global team of dedicated professionals who through their extraordinary efforts demonstrate every day their commitment to our mission of improving the lives of patients. At Orthofix our culture is built around Integrity and the core beliefs we live by: Exceed Expectations, Work Together, Be Respectful, Get Lean and Have Fun! As an Orthofix employee, you will become an integral part of our culture by continually demonstrating the highest level of integrity and our beliefs while making an impact to our vision “To be a highly respected global orthopedic and spine company that delivers exceptional value to our patients, customers, team members, partners and shareholders."
Auditor & Payer Resolution Specialist
How you’ll make a difference?
This person will assist with processing of all audits, with a as well as assist with 3PP reversals, write offs and refunds. Position intended to help an organization accomplish its objectives by bringing a systematic, disciplined approach to evaluate and improve the effectiveness of risk management, control, and governance processes.
What will be your Duties and Responsibilities?
Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
- Process monthly audits of federal and commercial patient accounts
- Process internal audit requests (example: Finance audit and Policy audits)
- Process additional audits as needed each month by management
- Assist with processing of external post pay audit requests within determined timeline and provide updates as necessary
- Assist with Medicare pre-pay external audit requests within determined timeline and provide updates as necessary
- Identifies issues in competency, data quality, sourcing, or documentation by reviewing existing data and processes and then provides recommendations to management for process improvements.
- Work with management to provide audit findings, quality metrics and presentations as required to highlight key audit findings and trends to Order to Cash (OTC) management
- Work with management to create and implement OTC management approved process improvement recommendations
- Re-audit as needed to assess the effectiveness of corrective and preventative actions taken.
- Assist in processing of OTC reversals, write offs and refunds
- Reads, analyzes, and interprets existing documents and data for completeness and accuracy.
- Works with various departments to remain current on policy, procedure and work instruction updates
- Ability to draft Standard Operating Procedures and Work Instructions
- Promote and exude a positive work environment.
- Understand and promote Compliance adherence.
- Timely completion of all corporate wide and departmental training.
- Regular attendance required
- Other projects as assigned
What skills you’ll need?
- Minimum 3 year’s experience in the healthcare industry
- Critical thinking, communication and analytic skills
- Exceptional computer skills including operation of Microsoft Office
- Demonstrated understanding of the company’s policies and procedures
- Demonstrated interpersonal skills, problem solving, and change management skills
- Knowledge of both internal and external quality standards
- Demonstrated time management
- Ability to support various departments within the company
- Ability to take an objective approach (or remain objective) while working with various departments within the company
NONESSENTIAL SKILLS, EXPERIENCE AND QUALIFICATIONS (not necessary but preferred):
- Project management skills
- Team leadership expertise
PHYSICAL DEMANDS AND WORK CONDITIONS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Regularly required to sit for extended periods of time; frequently required to stand, walk and use business equipment daily such as P.C., copier, fax, telephone, etc.; occasionally required to reach overhead, bend, and lift objects of up to 20 lbs.
- Eyesight and hearing must be correctable to standard level.
Orthofix complies with all applicable federal, state, and local laws regarding equal employment opportunities (EEO) to all employees and applicants for employment. Orthofix makes its employment decisions without regard to race, color, religion, sex, national origin, age, disability, genetic information, or any other status protected by law. In addition to federal law requirements, Orthofix complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has employees. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.