Medavie is a national health solutions partner dedicated to improving the wellbeing of Canadians. The Health Services Auditor role involves conducting audits to ensure compliance with billing policies, preparing reports on audit findings, and educating providers about audit requirements.
Responsibilities
- Prepare pre-audit material based upon type of audit to be conducted
- Schedule and co-ordinate on-site and remote audits to ensure efficient use of resources
- Analyze audit material collected considering content, documentation, and program rules
- Educate providers regarding audit requirements. Respond to enquiries from providers regarding audit related matters
- Prepare reports detailing audit findings. Discuss audit findings and recoveries with providers. Prepare and present case material to support the audit and appeal process
- Prepare and present audit material to leadership as required
- Maintain a computerized database of audit activity
- Liaise with Medical Consultants to review audit material
- Conduct contract evaluations of provider contracts to ensure providers are complying with contract requirements
- Review risk analysis to identify providers that require audits
- Assist in the development of audit plans and associated audit procedures, including assessment of risks, defining priority areas for deployment of audit resources, and specification of associated performance standards
- Communicate with Department of Health, providers, and internal staff regarding audit related matters
- Attend ad hoc and regularly scheduled meetings with the Department of Health and other allied bodies on audit related matters as necessary
- Acquire a good working knowledge of the policies and procedures associated with the Provincial Programs
Skills
- University or college diploma in a Health-Related Discipline and/or Financial Services Related Discipline is considered an asset or equivalent work experience
- Experience working in a medical related field and/or audit environment either through previous work experience or formal training
- English is required, bilingualism (English and French) would be considered an asset
- A background in health insurance and training industry with the functional and technical knowledge and skills to do the job at a high level of achievement
- High attention to detail, using logic and good judgment in decision making for when different situations and skills may call for different approaches
- Proven analytical skills involving large volumes of data, in addition to solid knowledge of computerized database systems and query tools
- Possess superior communication skills (oral, written, listening) and delivers information clearly and confidently
- Demonstrates the ability to tailor information and delivery to suit the nature of the material, audience, and situation
- Builds rapport, constructive and effective relationships and spends extra effort to put others at ease
- Ability to organize work and information in a well thought out manner to deliver on specific tasks and reporting deadlines
- Exhibits high levels of energy and perseverance in the pursuit of established goals
- Demonstrates an understanding of how the job contributes to the overall work unit and takes the initiative to help with problem situations
- Easily gains trust and support of peers, encourages collaboration, and is composed
- Seeks and is receptive to feedback and enjoys working with people both as part of a team and one-on-one
Benefits
- Various performance-based incentive programs
Company Overview
Medavie is a health solutions organization that deals with health care, health diagnosis and services in Canada. It was founded in undefined, and is headquartered in Dartmouth, Newfoundland, CAN, with a workforce of 5001-10000 employees. Its website is https://www.medavie.ca/en/.
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