Medicare Audit Specialist
A company is looking for a Priority Claims Specialist IV - Remote. Key Responsibilities Review complex claims and patient records to identify discrepancies in payments to Medicare providers Prepare complex claims reimbursement submissions and serve as an advocate for clinic administration on reimbursement issues Conduct internal and external data reviews to ensure compliance with CMS guidelines and medical policies Required Qualifications High school education or equivalent with 6 years of experience in payor policies and reimbursement Bachelor's degree preferred Licensed Medicare auditor or Certified Medical Audit Specialist preferred High level knowledge of Medicare audit, appeals, and reimbursement processes Experience with Electronic Health Records (EHR) and MS Office suite programs
A company is looking for a Priority Claims Specialist IV - Remote.
Key Responsibilities
Review complex claims and patient records to identify discrepancies in payments to Medicare providers
Prepare complex claims reimbursement submissions and serve as an advocate for clinic administration on reimbursement issues
Conduct internal and external data reviews to ensure compliance with CMS guidelines and medical policies
Required Qualifications
High school education or equivalent with 6 years of experience in payor policies and reimbursement
Bachelor's degree preferred
Licensed Medicare auditor or Certified Medical Audit Specialist preferred
High level knowledge of Medicare audit, appeals, and reimbursement processes
Experience with Electronic Health Records (EHR) and MS Office suite programs
