Auditor

• Determine appropriate routing for reimbursement of AIHP medical providers;
  Process AIHP Nation pharmacy and vision memberships;
• Support accounts/payable process (key vouchers for AIHP/OHEHR);
• Provide administrative support (minutes, field calls from claims hotline) to AIHP contractors;
• Assist in preparation of periodic reports and analysis;
• Assist in the implementation and maintenance of policies and procedures related to control and processing of payment requests;
• Manage the Unit's workflow, troubleshoot and report to supervisor when necessary;
• Respond to inquiries from providers and Nation billing clerks.

• General/Basic Understanding of the medical claims’ submission process, which includes analyzing Explanation of Benefits (EOB) forms to interpret payment information, ability to read and interpret Medicaid billing schedules and policies, as well as Current Procedural Terminology (CPTs) and Healthcare Common Procedural Coding System (HCPCS);
• General knowledge of automated accounting systems;
• Ability to analyze data and apply basic Generally Accepted Accounting Principles (GAAP) when necessary;
• Proficiency in Microsoft Excel and Word programs;
• Good written and oral communication skills, as well as good organizational skills.
• 2+ years’ work experience as a Medical Coder, Billing Specialist, or equivalent.

Work Schedule: M-F 8:30am – 5:00pm (40 Hour Work Week) OR 9:00am – 5:00pm (37.5 Hour Work Week)

Telecommuting: This position may be eligible for telecommuting up to 50% hours scheduled to work in a two (2) week pay period. For new hires, it is typical that the first six (6) weeks of the assignment would be on site, with the possibility of applying for a telecommuting work schedule at that point. All requests are reviewed based on operation need. A laptop and docking station would be provided for remote work use at that time.