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PFS Auditor
A company is looking for a PFS Auditor to review and appeal claims related to clinical validation and coding denials. Key Responsibilities Conduct SOX reviews and assess internal controls in billing processes Perform pre and post billing reviews to ensure quality standards and accuracy Monitor claims audit policies, report findings, and provide recommendations Required Qualifications 3+ years of relevant experience, including 2+ years in billing and coding Knowledge of CPT codes, medical terminology, and insurance plans Understanding of SOX compliance and billing/collection requirements Ability to adapt to a fast-paced environment and meet deadlines Excellent computer skills and understanding of accounts receivable
A company is looking for a PFS Auditor to review and appeal claims related to clinical validation and coding denials.
Key Responsibilities
Conduct SOX reviews and assess internal controls in billing processes
Perform pre and post billing reviews to ensure quality standards and accuracy
Monitor claims audit policies, report findings, and provide recommendations
Required Qualifications
3+ years of relevant experience, including 2+ years in billing and coding
Knowledge of CPT codes, medical terminology, and insurance plans
Understanding of SOX compliance and billing/collection requirements
Ability to adapt to a fast-paced environment and meet deadlines
Excellent computer skills and understanding of accounts receivable