Audit Specialist II - CarepathRx
Core
Ensuring accuracy, quality, and compliance of healthcare billing and revenue cycle operations, specifically for home infusion services.
Role type
Healthcare billing audit specialist
Builds
Accurate reimbursement practices and compliant billing operations
Domain
Healthcare / Home Infusion / Revenue Cycle
Required skills
Healthcare billing regulations knowledge, Claim review, Root cause analysis, Quality audit execution, SOP development, CPR+ software proficiency
Preferred skills
ICD-10, CPT-4, HCPCS coding knowledge, Medicare billing familiarity
Responsibilities
Coordinate and complete assigned payer audits within deadlines, Review claim submissions for accuracy and identify discrepancies, Conduct quarterly quality audits and perform quality checks for new employees, Perform claim denial audits and ongoing quality reviews, Identify recurring errors and support employee training initiatives, Contribute to the development and improvement of Standard Operating Procedures (SOPs)
Seniority
Mid-level, hands-on IC