If i had to audit the insurance of a hospital, who would be the people i have to audit?

Question

If i had to audit the insurance of a hospital, who would be the people i have to audit?

Answer 1

You don't audit the people, you audit the books:  accounts, policies and records.

Answer 2

I've worked as an auditor for hospital insurance payments.

You review the payments for insurance payments and compare them to the contract between the hospital and insurer.  If the insurance company underpaid, then you pursue payment of the correct amount.

(Examples - if the contract was supposed to pay for a percent of billed charges and the insurer paid a DRG rate.  Or if you had a contract for a DRG rate, but the patient was an outlier and you didn't get the extra payment, etc.)

Not a bad job.  I enjoyed being able to see the tangible results of how much money I recouped every month, etc.  And, of course, its good experience to learn about hospital reimbursement and set yourself up for future career opportunities.