Medical Billing Auditor

Job Summary

A company is looking for a Stop Loss Claims Auditor.

Key Responsibilities

• Review medical facility and professional claims for accuracy and compliance with coding rules and regulations
• Enter billing information into client report formats and apply contractual adjustments to medical charges
• Audit charges for CPT coding, verify accurate coding through medical records, and adhere to HIPAA guidelines

Required Qualifications

• High School Diploma or equivalent
• Minimum 2 years of Claims Coding or Medical Billing experience
• Knowledge of CMS-1500 and UB-04 Medical Claim Forms
• AAPC Certification and ICD-10 proficiency required
• Prior experience in the Self-Funded Industry is desired