Auditor

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Job description

Join Our Growing Healthcare Receivables Management Team as an

Auditor/Analyst

We are a fast-growing healthcare receivables management company seeking a full-time Auditor/Analyst with a solid background in medical billing and coding. If you're detail-oriented and passionate about improving revenue cycles, this is the perfect opportunity for you! In this role, you will analyze patient accounts, resolve claim issues, and collaborate closely with third-party payers to ensure timely payments.

Key Responsibilities:

Investigate patient accounts: Follow up on hospital claims, reviewing physician, outpatient, and inpatient accounts to identify issues causing payment delays or denials.

Tackle coding and documentation challenges: Analyze denials related to ICD-10 and CPT codes, and address medical necessity denials due to insufficient documentation or coding errors.

Dispute and appeal claims: Submit written disputes and payment claims as needed, and prepare strong appeals for authorization and administrative denials.

Collaborate for solutions: Work with various departments to gather the necessary information to resolve claims efficiently.

What We're Looking For:

High school diploma or GED required; Bachelor's degree preferred.

Coding certification (AHIMA or AAPC) is a plus!

3+ years of experience in a healthcare setting.

Proficiency in EPIC is a must.

ICD9/10 and CPT coding

Must know third party billling(Use of modifiers and COB rules

Third party websites

Read and interpret EOB

Word and Excel

Must know HIPPA and PHI guidelines

If you have the expertise to streamline medical billing processes and thrive in a collaborative environment, we'd love to hear from you!

Nesco Resource provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Pro038

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