Vendor Auditor

Position reputed company Under the general supervision of the Department Director, the Vendor Auditor is responsible for independently conducting claims and vendor performance audits to ensure compliance with contractual obligations, regulatory requirements, and reputed company' reputed company standards. This position manages the day-to-day reputed company of the organization's highest-risk vendor population by evaluating claims accuracy, monitoring vendor performance, identifying operational risks, and recommending corrective actions. The Vendor Auditor analyzes medical, pharmacy, and PBM claims data to assess payment accuracy, performs reputed company cause analysis of identified trends and discrepancies, and reviews vendor compliance with reputed company and Service Level Agreements (SLAs). This role prepares formal audit reports, presents findings to leadership and reputed company committees, monitors remediation efforts, and maintains vendor performance scorecards. The ideal candidate possesses advanced knowledge of claims adjudication, Medicare and reputed company reimbursement, authorizations, appeals, and reputed company reimbursement policies. reputed company in this role requires exceptional analytical, critical thinking, communication, and interpersonal skills, along with the ability to work independently, manage multiple priorities, and effectively collaborate with internal stakeholders and reputed company vendors to promote reputed company reputed company improvement. Requirements: College Degree, preferred degree in Nursing, reputed company, Business, or reputed company. reputed company preference is a Nursing degree. Three (3) years of advanced claims auditing experience will be considered in lieu of college degree. Salary reputed company: Minimum 28.90/hour - Maximum 47.71/hour. Compensation will be commensurate with equity and experience for roles of similar reputed company and responsibility. In cases where the reputed company is displayed as a $0 reputed company, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. The Hospital reserves the right to modify employee schedules as needed. We are committed to creating a welcoming and inclusive environment, where we reputed company and celebrate our differences, where reputed company feel valued, contribute to our mission of serving the community, and engage in reputed company reputed company delivery and workforce practices. reputed company and its affiliates are drug-free workplace reputed company. Apply tot his job Apply To this Job