Review, analyze, and complete pre- and post-payment claim audits and appeals in accordance with client policies, CMS guidelines, and healthcare industry standards.
Apply clinical judgment to evaluate documentation and determine the appropriateness and accuracy of claims.
Interpret and apply payer policies and regulatory requirements across areas such as itemized bills, DRG reviews, and specialty audits.

Requirements:

Maintain an active LPN, LVN, and/or RN license.
Bring at least 1 year of relevant professional experience or an equivalent combination of education and experience.
Have at least 1 year of experience in healthcare revenue cycle and 1 year of hospital bill auditing experience.

Benefits:

Salary range: $66,941–$101,258, with compensation determined by factors including location, experience, qualifications, skills, internal equity, and market conditions.
Remote work arrangement.
Medical insurance, including HDHP options with pharmacy coverage.

Jobgether

Our partner company focuses on ensuring healthcare claims are reviewed accurately, consistently, and in accordance with applicable policies and industry standards. It is a collaborative, fast-paced, and evolving environment with opportunities for professional development and career advancement.

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