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The Audit Management Analyst will serve as an organizational expert on current payer audit processes and principles and will complete and communicate the status of hospital facility claims audits by third parties conducted to reduce payment for reasons other than the medical necessity of care. The Audit Management Analyst will coordinate with internal and external resources to ensure contractual and payer requirements are executed accurately, thoroughly, and efficiently, and will communicate with third party payers and their contractors toward actionable outcomes. This role will also collaborate with operational Directors and Clinical Leaders to identify strategic solutions and coordinate proactive initiative follow-up in order to reduce or limit the opportunity for audit-related payment denials. The Audit Management Analyst will have responsibility and oversight of the claim audit appeal process as well as analyze and provide reports addressing audit trends across payers and vendors. This role will also be tasked with developing recommendations to mitigate revenue loss.

Required Education and Experience

Bachelor’s degree or higher, or the equivalent combination of education and relevant experience.

Minimum of five years experience working at a payer or hospital in a relevant role involving provider/payer relationships.

Working knowledge of claim processing, auditing processes and principles, and appeal processes and principles.

Required Credentials

N/A.

Preferred

Bachelor’s degree or above.

Prior experience using Epic Operating System and Cerner’s Clinical Information System (CIS).

Prior payer/provider negotiation experience.

Prior experience with Revenue Cycle operations.

Compensation Range

$73,378.00 - $110,066.00 per year

Salary Information

This compensation range was calculated based on full-time employment (2080 hours worked per calendar year). Offers are determined by multiple factors including equity, skills, experience, and expertise, and may vary within the range provided.

Disclaimer for Out of State Applicants

This compensation range is specific to Seattle, positions located outside of Seattle may be compensated differently depending on various factors **.**

Benefits Information

Seattle Children’s offers a generous benefit package, including medical, dental, and vision plans, 403(b), life insurance, paid time off, tuition reimbursement, and more. Additional details on our benefits can be found on our website www.seattlechildrens.org/careers/benefits .

About Us

Hope. Care. Cure. These three simple words capture what we do at Seattle Children’s – to help every child live the healthiest and most fulfilling life possible. Are you ready to engage with a mission-driven organization that is life-changing to many, and touches the hearts of all? #HOPECARECURE

Our founding promise to the community is as valid today as it was over a century ago: we will care for all children in our region, regardless of the families’ ability to pay. Together, we deliver superior patient care, advance new discoveries and treatments through pediatric research, and serve as the pediatric and adolescent, academic medical center for Washington, Alaska, Montana and Idaho – the largest region of any children’s hospital in the country.

As a Magnet designated institution, we recognize the importance of hiring and developing great talent to provide best-in-class care to the patients and families we serve. Our organizational DNA takes form in our core values: Compassion, Excellence, Integrity, Collaboration, Equity and Innovation. Whether it’s delivering frontline care to our patients in a kind and caring manner, practicing the highest standards of quality and safety, or being relentlessly curious as we work towards eradicating childhood diseases, these values are the fabric of our culture and community. The future starts here.

Our Commitment

Seattle Children’s welcomes people of all experiences, backgrounds, and thoughts as this is what drives our spirit of inquiry and allows us to better connect with our patients and families. Our organization recruits, employs, trains, compensates, and promotes based on merit without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

The people who work at Seattle Children’s are members of a community that seeks to respect and celebrate all the qualities that make each of us unique. Each of us is empowered to be ourselves.

Seattle Children’s is proud to be an Equal Opportunity Workplace and Affirmative Action Employer.