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Payment Audit Coordinator, Geisinger Health Plan (Work from Home Pennsylvania resident)
Job SummaryResponsible 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 DutiesUtilizing 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.


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