Hospital Charge Audit Support – Eligibility & Payment Analysis job vacancy in Change Healthcare (Wisconsin)

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Company name : Change Healthcare
Location : Wisconsin
Position : Hospital Charge Audit Support – Eligibility & Payment Analysis

Description :
Hospital Charge Audit Support – Eligibility & Payment Analysis

Overview of position:
The Hospital Charge Audit Support – Eligibility & Payment Analysis position is a member of the Post-pay Eligibility (PPE) group within the Hospital Charge Audit team and support our auditors and audit process.

What will be my duties and responsibilities in this job?

Perform pre-audit and post-audit analysis of claims and client contract information
Utilize Payer claim systems to review and analyze claims in order to verify eligibility and determine the payment methodology, exclusions and non-covered charges
Screen clients’ online systems for published changes such as new, modified and/or updated contracts/agreements/amendments and fee schedule
Complete client compliance training and maintain access to client systems

Research and respond to refund recovery team inquiries and/or other operational inquiries
Provide feedback on claims received that are not paying percent of charge for review by the Contract team
Review existing processes and suggest improvements
Other duties as assigned

What are the requirements needed for this position?

High School Diploma or GED
3+ years of experience in medical claim processing, review and/or contract analysis
Intermediate level proficiency with MS Office: Excel, Word and Outlook

What other skills/experience would be helpful to have?

3+ years of experience in group/individual health claim benefits services
Experience with hospital charge audit process
Ability to interpret client-provider contracts and extract necessary information to support the audit process
Understanding of insurance payment methodology and the ability to calculate correct payment amounts for claims including, but not limited to: Per diem, stop loss, percent of charge, case rate
Strong planning, organizational, problem solving and time management skills with the flexibility to adjust to changing priorities
Demonstrated ability to produce a high volume of accurate work in a fast-paced environment
Effective verbal and written communication skills and able to develop effective relationships
Work independently to make decisions and confident in supporting those decisions

What are the working conditions and physical requirements of this job? General Office Duties

How much should I expect to travel?
Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

COVID Vaccination Requirements

We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at and the supplemental information at

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to with “Applicant requesting reasonable accommodation” as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here to view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information.

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

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