Contract Auditor - Healthcare
Connolly  is a healthcare industry leader specializing in financial auditing, consulting and payment error identification services to commercial and government insurers across the country. We are a growing and profitable international recovery audit firm that serves clients in healthcare, retail, and commercial industries.
  Responsibilities will include but is not limited to:

• Investigate medical claim data in conjunction with insurance payer contracts to identify payment errors
• Analyze contracts with healthcare providers to identify potential overpayment opportunities
• Research & development of new payment error projects/reports based on provider contract analysis and industry trends
• Validate provider contract rates and payment rules on client systems
• Communication with management & client on audit findings, assist with error validation process
• Audit, mentor and support; suggest improvements and recommendations to meet the highest level of client satisfaction and quality standards.

Qualification Requirements:

• 5 + years managed care contracting and/or analytics experience
• 5+ years healthcare claims/reimbursement experience
• Bachelors Degree or equivalent certification
• Proficient with all healthcare coding (CPT4, HCPCS, DRG, ICD-9, & Revenue Codes) 
• Proficient with healthcare claim adjudication standards & procedures
• Strong Analytical & Investigative Skills
• Proficient in Microsoft products, especially Access and Excel 
• Ability to work independently & as part of a productive audit team 

Additional Helpful Experience/Qualities:

• Previous managed care contract negotiation experience
• Previous experience in hospital reimbursement and/or revenue maximization
• Previous Claims Resolution Specialist experience 
• Previous auditing experience

Success factors
Personal characteristics that contribute to an individual's ability to excel on the job.
Connolly Consulting’s Non-Negotiable Values 

• Integrity
• Self-Motivated
• Passionate
• Team Player
• Results Oriented
• Reliable
• Professional
• Boundaryless Behavior

Connolly Consulting's most important resource is experienced, committed, and creative employees. The open and inclusive team-oriented culture encourages contribution and enables employees to go beyond to fulfill his or her potential. Connolly is unique in its uncompromising commitment to provide the highest level of quality in auditing services. Connolly offers careers with plenty of challenge and opportunity, in a rewarding atmosphere. If you have a proven track record of accomplishment, commitment, and passion for success then Connolly is the right choice for you.

CB*  ~Y~