Remote Healthcare Documentation Auditor

Location: Nationwide

Compensation: To Be Discussed

Staff Reviewed: Wed, Jan 27, 2021

This job expires in: 1 days

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Some College

Job Summary

A financial services company specializing in technology-enabled audit, recovery, customer care, and related analytics services is filling a position for a Remote Healthcare Documentation Auditor.

Individual must be able to fulfill the following responsibilities:

  • Perform timely and effective reviews to assess documentation and billing accuracy for post and prepayment claims on behalf of Government, and Commercial Payers
  • Review medical records for services billed and validate required documents
  • Apply local coverage determination (LCD), national coverage determination (NCD), and commercial payer policy to services in review

Position Requirements Include:

  • Knowledge of insurance programs, particularly the coverage and payment rules
  • Demonstrated knowledge of medical terminology
  • High School Diploma or GED
  • 2+ years’ experience in adjudicating/examining claims for an Commercial Insurance Company, Tricare, MAC or organizations performing similar functions
  • 5+ years’ experience of provider professional billing, coding and documentation practices in outpatient setting
  • Experience with ICD-9, ICD-10, CPT-4 or HCPCS coding

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