POSITION LOCATION: Knoxville, TN
DESCRIPTION: Healthcare Horizons, an industry-leader in healthcare claims auditing for self-insured employers, is seeking a qualified Audit Project Manager to join our team. This individual will serve in a leadership role and contribute to the future success of Healthcare Horizons. The ideal candidate will exhibit competencies and potential to rise to an Executive Leader.
RESPONSIBILITIES:
- Manages and performs healthcare claim audit projects for self-insured employers
- Actively manage a portfolio of client engagements with a focus on identifying trends and anomalies in healthcare claims data
- Advises Healthcare Horizons clients regarding reimbursement matters and strategies throughout the process, resulting in high-yield investment returns
- Lead and develop a team of claim auditors and other service line subject matter experts to deliver exceptional client service
- Participate in business development initiatives to include creating and maintaining business relationships with current and future clients and gaining the confidence of top-level client personnel regarding the breadth of services offered by Healthcare Horizons
REQUIREMENTS:
- Bachelor’s degree from an accredited college/university; accounting, finance, or healthcare focus preferred
- MBA, MPH, MHA, or other graduate level master’s degree a plus
- 10+ years of experience in a healthcare environment – preferably with larger payer organizations (TPA), including claims adjudication supervision
- Expertise in project management of medical claims audit services required
- Pharmacy claims audit experience preferred
- Thorough understanding of claims adjudication processes required
- Willingness to travel for client projects and development opportunities
- Sound judgment with ability to manage risk effectively
- Superior communication skills, both oral and written
- Traits that include: detail-oriented, flexible, and responsive
- Ability to effectively work as a team player
- Client-oriented work ethic, delivering high-quality results
- Creative problem solver with a high level of strategic, analytical, and conceptual skills and a passion for helping clients
ABOUT HEALTHCARE HORIZONS
Healthcare Horizons Consulting Group, Inc. is one of the most trusted and people-centered expert healthcare claims auditing firms in the nation, focused exclusively on self-insured employers. The company is a leading expert in providing healthcare claims audit services, identifying overpaid or erroneous claims through its 100% Difference model, recovering millions of dollars for clients’ bottom lines with uncompromising ethics and accuracy. Healthcare Horizons is committed to putting people and relationships first, offering a streamlined process with high-yield return on investment, making the clients’ financial interest its number one priority. Since 1999, the Knoxville, Tennessee-based company has provided superior healthcare claims audits for some of the world’s largest self-insured employers, involving all national and most regional payers.
Please apply to: hhadmin@healthcarehorizons.com