Payment Integrity Specialist

Overview

This role is remote in Australia. Working as a part of our Payment Integrity Practice, the Payment Integrity Specialist provides claims audit and recovery services to our private health insurer clients and provide expert feedback to improve our compliance solutions.

Responsibilities

• Audit healthcare claims on behalf of our private health insurance clients to detect and recover overpayment.
• Review clinical documentations submitted by providers.
• Provide insights into hospital billing practices that will improve the Company’s ability to detect and recover overpayments.
• Support the growth of the Payment Integrity Practice by supporting business development activities.
• Strictly respect the confidentiality of all sensitive company and client information.

Qualifications

• One of the following qualifications: Bachelor’s Degree (Nursing or equivalent) with experience in...