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Aveanna Healthcare

Home-based medical care and caregiver support.

Contract Modeling Auditor

AuditingConfirmed live in the last 24 hours
Full-timeGeorgia, USANo salary listed

About the Job

Requirements

  • High school diploma.
  • Ability to work independently with little supervision.
  • General knowledge of healthcare contract modeling.
  • Extensive knowledge of Medicare, Medicaid, and payer-specific guidelines is preferred.
  • Ability to multitask.
  • Experience with Microsoft Office Suite, including Word, Excel, PowerPoint, and Teams.
  • A college degree is preferred.
  • Cisco Security Certification is a plus.
  • Ability to adhere to confidentiality standards and professional boundaries at all times.
  • Ability to speak, write, read, and understand English.
  • Ability to lift, carry, push, and pull 25 pounds occasionally.
  • Ability to walk, sit, stand, bend, kneel, reach, and twist for prolonged periods.
  • Ability to sit and climb stairs.
  • Visual and hearing acuity, and a strong sense of smell and touch.

Responsibilities

  • Review, research, and check the accuracy of loaded contracts, single case agreements, and service setup within Aveanna EMRs, including pricing, coding, and products for commercial, Medicare, and Medicaid payers.
  • Understand payer contracts, state and national guidelines, and the contract management system as appropriate.
  • Obtain an accurate understanding of contract language, billing requirements, and fee schedules.
  • Work with Contracting to resolve issues and clarify contract terms.
  • Audit contract terms loaded by the SIMs team for accuracy and expected revenue, including service codes and products, standard and expected rates, rounding, and effective dates.
  • Recognize and recommend changes as needed based on the contract and system configuration.
  • Work with Compliance to resolve issues and clarify Medicare and Medicaid billing requirements.
  • Maintain a hard-copy contract file.
  • Provide customer service.
  • Ensure that procedures and assigned duties comply with SOX regulations.
  • Evaluate data, reports, feedback, observations, and other information to determine priorities.
  • Use prior knowledge and industry-specific historical experience to resolve problems.
  • Perform job functions relying on instructions and pre-established guidelines.
  • Use professional communication and conflict-resolution techniques as required.
  • Reflect the company mission, values, and strategic imperatives when completing or assigning work.
  • Conduct assignments professionally, serve as a role model, and act with a sense of urgency.
  • Perform other duties as assigned by the supervisor.
  • Perform duties in an office environment during agency operating hours and function in a wide variety of environments that may involve exposure to allergens and other conditions.

Desired Qualifications

  • Extensive knowledge of Medicare, Medicaid, and payer-specific guidelines.
  • A college degree.
  • Cisco Security Certification.
  • Attention to detail.
  • Time management.
  • Ability to remain calm and professional in stressful situations.
  • Commitment to excellence.
  • Quick thinking and astute decision-making.
  • Problem-solving and conflict-resolution skills.
  • Organization and communication skills.

About the Company

Aveanna Healthcare

Home-based medical care and caregiver support.

Aveanna Healthcare provides in-home medical and caregiver services across 33 states through a network of 300+ branch offices, serving more than 40,000 children and adults. Its offerings include a range of home-based care and support services designed to help patients stay at home rather than in facilities. The company operates by coordinating a local team of caregivers with clinical resources and training, delivering care directly to patients’ homes and leveraging technology to support the caregiver-patient relationship. It differentiates itself from competitors by emphasizing strong caregiver-patient relationships, comprehensive resources, advanced training, and a national-scale network to drive better outcomes in daily living and clinical care. Aveanna’s goal is to enable better quality of life and improved health outcomes for patients and families by delivering high-quality, compassionate homecare in the home setting.

Company size
10,001+
Company stage
IPO
Headquarters
Atlanta, GA
Founded
2017

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