Provider Administration Auditor

  • Provider Administration
  • Fort Lauderdale, FL
  • 1 year ago
  • 1 available

Job Description

Audits Provider Contract Module to ensure compliance with policies and procedures. Ensures that protocols are followed with regard to provider contract, contract reimbursement, established guidelines.

Essential Functions & Responsibilities

  • Conduct audits of the entry made into the Provider Admin Module to ensure the accuracy in entry and to ensure adherence to the department’s contract loading guidelines.
  • Review and audit all contract uploads performed by IT to ensure the upload was performed accurately.
  • Review and audit provider entries by the staff as a result of a claim edit.
  • Review and audit all contract entries by the staff as the result of a request from Network Management, Credentialing and/or Utilization Management.
  • Review and audit custom fee schedules created and updated by the provider admin team

Required Education and Experience

  • Minimum 3 years experience in a medical office claims environment with emphasis in provider contracting for purposes of systemic administration.
  • Knowledge of Medicare, Medicaid and Commercial lines of business.
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Date Posted:

Nov 11, 2022


Fort Lauderdale, FL

Job Title

Provider Administration Auditor


Provider Administration


40h / week

  • Primary industry: Healthcare
  • Company size: 250 - 300
  • Founded in: 1999
  • Phone: 1-800-595-9631
  • Headquarter: Fort Lauderdale, FL
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