Audit Specialist

Job Summary

Maintaining compliance with billing audits, the full-time Audit Specialist will analyze health plan reimbursement policies, manage documentation for Medicare, Medicaid, and commercial health plans, and coordinate with internal teams and physicians to ensure accurate submissions in a fully remote environment.

Key responsibilities

• Log and report all received audit inquiries and documentation requests
• Retrieve and review documentation for completeness and accuracy to support audit submissions
• Assist with tracking and reporting of audit findings and implement performance improvement programs related to billing and coding

Required qualifications

• High School Diploma or equivalent
• One year of work-related experience in healthcare administration, financial services, or insurance
• Two years of work-related experience is required for senior-level positions
• Experience in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment is preferred
• Knowledge of Medicare, Medicaid, and commercial health plan reimbursement methodologies