
Medical Claims Auditor
13 hours ago
Job Title: Medical Claims Auditor
">- The successful candidate will be responsible for auditing and evaluating the accuracy and effectiveness of Accounts Receivable functions.
- This role involves reviewing claim resolution workflows to ensure adherence to client-specific guidelines and compliance standards.
- You will identify quality gaps and provide actionable feedback to AR executives and team leads.
About the Role: We are seeking a detail-oriented professional with experience in US healthcare RCM, specifically in AR follow-up.
Responsibilities:
- Audit AR-related activities such as insurance follow-ups, aging buckets, denial handling, and collections.
- Review claim resolution workflows to ensure adherence to client-specific guidelines and compliance standards.
- Identify quality gaps and provide actionable feedback to AR executives and team leads.
- Track error trends, perform root cause analysis, and suggest corrective measures.
- Maintain detailed documentation of audit results and participate in calibration sessions.
Requirements: 1-2 years of experience as a Quality Analyst in US healthcare RCM, specifically in AR follow-up. Strong knowledge of denial types, AR workflows, payer communication, and appeals process. Hands-on experience with tools like Cerner, Athena, Epic, AdvancedMD or similar billing platforms.
Why Work with Us: Complimentary medical coverage for your family, retirement savings and insurance benefits, transparent performance reviews and growth support, employee rewards through the Pixel Workplace Recognition Program, work-life balance with a supportive collaborative culture.
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