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
