Join the BMI team.

Senior Auditor

Location: Remote
Type: Full-Time
Salary Range: $60,000 to $70,000 annually

WHO WE ARE

BMI is a healthcare benefits auditing firm founded in 1998 and specializes in healthcare cost containment. Our purpose is to help organizations uncover who and what their healthcare dollars are being spent on. Our national client base consists of organizations with fewer than 100 employees to Fortune 500 firms and public entities who rely on us to provide claims audits of third-party administrators/carriers and dependent eligibility audit services.

position overview

Reporting to the Senior Director, Client Delivery, the Senior Auditor is responsible for serving BMI clients by participating in all aspects of BMI’s claims audit processes as well as strategically supporting the project’s kick-off through completion. This position will work closely with the rest of the Client Delivery Team – ensuring that everything we do is for the betterment of our clients. Utilizing proprietary software, this position involves reviewing medical or pharmacy benefit plan documentation and provisions against actual claims paid or claims paid scenarios to identify potential issues.

This can be a remote-based position within the continental United States. Currently, all on-site audits are being performed remotely. If this changes then an average of 45% travel is expected domestically.

Essential duties + responsibilities

Essential duties and responsibilities include, but are not limited to:

• Participate in all phases of the audit process and reporting to meet internal and external timeframes.

• Assist with coordinating work for the auditing team to ensure that the client specific deliverables are meeting deadline requirements.

• Trains, supports, and mentors the new auditors.

• Works with a focus to make sure the deliverables are accurate, thorough and high quality.

• Conduct quality assurance checks on all client deliverables.

• Conduct on-site and in-house healthcare claims audits to ensure proper healthcare claim adjudication practices were followed by the claims administrator according to client intent.

• Partners with Sales Team for holistic service delivery.

• Participates in the sales process during demos and proposals.

• Works cross-functionally with the Client Delivery team members (auditors, project managers) to assure service and partnership plans directly support the account plan for the client, and that services are setup, maintained and delivered in the form that meets the clients’ needs and is within the scope of the contract.

• Performs other duties as assigned.

requirements

• Preferably 7 years + of employment with a company; or equivalent experience in a healthcare audit setting; or a certificate/diploma in medical billing and/or coding may be substituted for healthcare experience.

• Proven excellence in the support and service to complex clients.

• Ability to build strong relationships, foster trust and create a supportive environment for training and mentoring team members.

• Excellent verbal and written communication to clearly explain concepts, provide feedback, and actively listen to other team members.

• Proven ability to manage multiple audits simultaneously and meet deadlines.

• Exceptional attention to detail and ability to work with large volumes of data.

Desired Skills

• Superior problem-solving ability, preferably within a client environment.

• Strong analytical and critical thinking ability.

• Strong ethical and professional conduct with a commitment to objectivity and confidentiality.

• Proficiency with Microsoft Office (Word, Excel, Outlook, PowerPoint, etc.) and video conferencing.

WORK ENVIRONMENT

This position is a remote position within approved states. This job operates in a professional office environment, whether in person or remotely. This role routinely uses standard office equipment such as computers, phones, and printers. Equipment will be provided to you.

what’s in it for you?

• Medical, Dental and Vision Benefits

• Health Savings and Flexible Spending Account Options

• 401(k) with Automatic Company Contribution

• Employee Assistance Program

• Company-paid Life and Disability Insurance

• Paid Time Off