Medicare Audit Specialist

Job Summary

A company is looking for a Priority Claims Specialist III - Remote.

Key Responsibilities

• Review complex claims and patient records to identify discrepancies in Medicare payments
• Prepare complex claims reimbursement submissions and assess risks of denial or audit
• Consult with physicians and manage relationships with clinics and insurance organizations regarding reimbursement issues

Required Qualifications

• High school education or equivalent with 4 years of related experience in payor policies and reimbursement
• Bachelor's degree preferred
• Licensed Medicare auditor or Certified Medical Audit Specialist preferred
• Working knowledge of Medicare audit, appeals, reimbursement, and medical terminology
• Experience with Electronic Health Records (EHR) and MS Office suite programs