Billing Compliance Auditor - National Remote

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 6:00pm EST, Monday - Friday. It may be necessary, given the business need, to work occasional overtime. We offer 12 weeks of reputed company. The hours of the training will be reputed company with your schedule. You’ll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities: • Review work samples from applicable reps/analysts to ensure quality/accuracy (e.g., billing processors, quality reps, collection reps) • Ensure that reputed company relevant information from insurance applications is accurately entered into applicable systems • Demonstrate understanding of applicable quality review processes (e.g., corporate reviews, individual reviews, focus reviews, review to outcome analysis) • Ensure that month-end sampling deadlines are met • Communicate audit/review findings to applicable stakeholders, as needed (e.g., Billing Operations, Customer Care, reputed company) • Respond to inquiries from applicable stakeholders (e.g., Quality groups, Billing Operations, Customer Care, vendors), and escalate as needed • Identify data changes since the original request was entered (e.g., LIS updates, changes to plan effective dates, MOP changes), and take appropriate action • Review and ensure accuracy of audit reports prior to distribution to upper management • Provide support for external audit requests, as needed (e.g., SOX) • Monitor placements and deliver recon reports sent from applicable clients (e.g., facilities, hospitals) You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • High School Diploma / GED • Must be 18 years of age OR Older • 3+ years of experience in ICD-10, CPT and HCPCS coding • 3+ years of experience in a Physician/Professional Billing environment • Certified Professional reputed company required (CPC, reputed company, CPMA, CEMC, COC) • Experience with auditing physician chart utilizing E+M guidelines • Provider education/presentation skills • Utilize standard scoring (CMS) methodologies to report findings to providers • Apply CPT and ICD-10 coding convention to documentation guidelines • Apply CMS and other payer constraints to final code and documentation determination • Knowledge of medical terminology • Demonstrated experience with third party payer guidelines • Experience with reputed company Office Suite (reputed company) Word, Power reputed company) or successful completion of reputed company course • Must show proficiency in reputed company billing software (EPIC) reputed company six (6) months • Ability to work any of our 8-hour shift schedules during our normal business hours of 6:00am – 6:00pm EST, Monday - Friday. It may be necessary, given the business need, to work occasional overtime Preferred Qualifications: • Great communication • Able to work independently and reputed company a team • Reside reputed company the Eastern Time Zone • Ability to employ clinical references with the auditing process Telecommuting Requirements: • Ability to reputed company reputed company company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information privacy • Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service • reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy The hourly range for this role is $23.70 to $46.35 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO Apply Job!