Claims Audit Extern

Job Summary

Supporting claims audits and quality assurance reviews, the full-time Claims Audit Extern will gain hands-on experience in healthcare claims auditing while working remotely with provider clinics and cross-functional teams to ensure coding accuracy and compliance.

Key responsibilities

• Participate in claims audits, including selecting patient claim samples and validating coding and billing accuracy
• Document audit findings and prepare comprehensive audit reports and required documentation
• Educate provider clinics on audit findings and coding requirements, while assisting with special projects as needed

Required qualifications

• CPC-A, CPC, CCA, CCS, or CCS-P certification required
• Strong proficiency in Microsoft Office, especially Excel, with experience in managing large datasets
• Working knowledge of CPT, HCPCS, ICD-10-CM coding, and healthcare claims concepts
• Ability to work independently in a fast-paced environment while managing multiple priorities
• Interest in healthcare audit, coding, payment integrity, and process improvement