This is a full-time, remote position on the Coventry Network Support team. This role can be performed anywhere in the United States.
The Auditor reviews issues, contracts, supporting documents, pricing claims, and any other necessary systems to ensure claim and rates are correct.
- Resolves high level pricing disputes
- Auditing Rate Load Auditors to ensure accuracy
- Provides direction on how to price PPO pricing edits
- Communicates with contract negotiators for clarification on contract language
- Performs pricing verifications on disputed bills
- Answer general and provider questions from negotiators
- Performs various duties in support of Rates Load & Rates Auditing teams
- Provides on-going support in research and analysis essential to resolving concerns/issues tied to provider setup
- Demonstrated PC skills, including Microsoft Office products and Internet navigation skills, Basic Excel
- Demonstrated effective communication skills, both verbal and written
- Experience with CPD & PCM preferred
- Minimum 2 years PPO Network experience
- High school diploma/GED required, Bachelors preferred