Medical Bill Audit Specialist
A Medical Bill Audit Specialist is responsible for reviewing, analyzing, documenting, and creating audit reports within time and quality assurance standards.
Responsibilities
Including, but not limited to:
Forensic Review
- Complete level two pre-screen reviews, including levels of care and exception detail; conduct a quality assurance review of the initial analysis
- Complete forensic reviews, including identifying and/or researching new exceptions and arguments, and compile documentation to support exceptions
- Conduct quality assurance reviews of pre-screen and forensic review reports prepared by other forensic review specialists
- Release reports to clients with appropriate communication
- Perform research as assigned
- Interact with clients and consultants as requested
- Document all communications according to company standards
- Meet time and quality assurance standards
Other
- Participate in department and company meetings as requested
- Complete special projects as assigned
Qualifications
Education and Certifications
- Bachelor's Degree; emphasis in healthcare administration, accounting, or finance preferred
- Medical bill coding certifications helpful
Experience
- 3-5 years of experience in medical billing/coding or claims review
- Familiarity with medical terminology helpful
Skills
- Advanced computer skills, specifically Excel
- Strong organizational skills and attention to detail
- Ability to multi-task and work with little direction
- Good verbal and written communication skills
- Team player
