Medical Bill Auditor

CompIQ Solutions•Middletown, OH

8d•Hybrid

About The Position

The Medical Bill Auditor supports the AuditIQ Bill Review Service Operations team. This role is responsible for conducting line-level audits for a sub-set of medical bills processed by Bill Review Operations. These audits compare payment allowances against fee schedule rules/guidelines, coding guidelines issued by the AMA CPT Manual, national societies and prevailing industry standards.

Requirements

Certified Professional Coder (CPC) certification or another coding credential from AHIMA or AAPC is required (Note: We cannot accept a CPC-A certification)
2+ years performing audits against medical records for correct coding

Nice To Haves

Associate or bachelor’s degree in nursing, medical coding, healthcare or related field preferred but not required.
Familiarity with the CompIQ Bill Review Platform preferred but not required

Responsibilities

Conducts in-depth audits and reviews medical bills that meet escalated criteria from the bill review operations team.
Audits medical bills for appropriate, necessary, and any applicable unrelated charges.
Reviews payment recommendations against applicable fee schedule allowances, regulatory or administrative charges, coding, and identifies billing errors to determine if fraud or inaccurate billing.
Performs bill review functions in compliance with established client-specific rules and workflows that may change from time to time as well as CompIQ internal processing standard operating procedures.
Reviews provider appeals and state disputes to determine if additional monies are due to the provider.
Assists in the development and implementation of new audit/review methodologies to identify overpayments and underpayments to providers.
Applies knowledge of provider billing and patient accounting practices to the research of client policy and data to reveal new overpayment recovery opportunities.
Develops, maintains, and ensures adherence to multiple project schedules.
Achieves percent of savings expectations through their review billing.
Ensures productivity goals are met daily.
Communicates audit and review issues and results to supervisors and managers.
Participates in planning, daily meetings, and backlog sessions.
Performs other duties as assigned by supervisors and managers.
Complies with all company guidelines, code of conduct, policies, and standards.

Benefits

Fair and Competitive Salary
Flexible schedule in a hybrid or remote-work environment (depending on location)
Flexible Paid Time Off
Paid Parental Leave
Tuition Reimbursement
Identity Theft Protection
Medical, Dental, and Vision Insurance
100% Company-paid Short-Term and Long-Term Disability
100% Company-paid Life Insurance with additional voluntary enrollment options
Employee Assistance Programs including counseling with up to 6 complimentary sessions
Monthly Wellness (Gym Membership) Stipend
Health Spending Account (HSA) and Flexible Spending Account (FSA) Programs
401(k) Plan with a 100% vested company match
Career development and growth opportunities