Licensed Medicare Audit Specialist
A company is looking for a Priority Claims Specialist IV - Remote. Key Responsibilities Review complex claims and patient records, identifying discrepancies in payments to Medicare providers Prepare complex claims reimbursement submissions and serve as an advocate for clinic administration regarding reimbursement issues Conduct analytical research on pricing, reimbursement, and claim appeals processes while maintaining relationships with insurance organizations Required Qualifications High school education or equivalent 6 years of experience with payor policies, reimbursement, and medical policy Bachelor's degree preferred Licensed Medicare auditor or Certified Medical Audit Specialist preferred High-level knowledge of Medicare audit, appeals, and reimbursement processes
A company is looking for a Priority Claims Specialist IV - Remote.
Key Responsibilities
Review complex claims and patient records, identifying discrepancies in payments to Medicare providers
Prepare complex claims reimbursement submissions and serve as an advocate for clinic administration regarding reimbursement issues
Conduct analytical research on pricing, reimbursement, and claim appeals processes while maintaining relationships with insurance organizations
Required Qualifications
High school education or equivalent
6 years of experience with payor policies, reimbursement, and medical policy
Bachelor's degree preferred
Licensed Medicare auditor or Certified Medical Audit Specialist preferred
High-level knowledge of Medicare audit, appeals, and reimbursement processes
