Payment Audit Coordinator, Geisinger Health Plan

3 weeks ago


Danville, United States Geisinger Full time

**Job Summary**: Responsible for initiating and maintaining all audit processes including but not limited to scheduling, updating, and tracking for the Audit function related to Provider Payment Integrity. The Audit Coordinator facilitates the opportunities for established metrics and target recovery goals to be achieved.

**Job Duties**:

- Utilizing Audit criteria and guidelines, reviews claims loaded through the Claim Audit Database to identify recovery opportunities.
- Selects and assigns claims for staff to audit.
- Interfaces with External Providers to coordinate audit projects.
- Organizes audit project records, tracks incoming provider itemized bills and profiles, and confirms itemized bills and pharmacy profiles are prepared and available for review.
- Maintains department databases, calendars, logs and filing systems.
- Participates in project development and research.
- Develops and generates reports for ad hoc data as requested.
- Manages record retention policies and procedures.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
- Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years).

**Position Details**:
**Internet requirements**:
***Employee required to have/supply: Cable modem, (high speed, only - No DSL or Wireless Cellular Service or Satellite Service) The minimum requirement is:

- 25 MBPS UP
- 75 MBPS DOWN
-



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