Medical Bill Auditor

Description

Who we are…

CompIQ Solutions is a software and full-service provider focusing on the property and casualty medical bill review market. We provide an end-to-end solution for our clients leveraging our proprietary technology and software platforms in the delivery of our solutions and services. We focus our efforts on our three key stakeholders, in this order: 1) Clients; 2) Colleagues; 3) Company.

About This Role

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.

Duties And 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
• Additional duties as assigned by manager
  
  

Requirements

Education/Certificates

• High School Diploma or equivalent
• Associate or bachelor’s degree in nursing, medical coding, healthcare or related field preferred but not required.
• Certified Professional Coder (CPC) certification or another coding credential from AHIMA or AAPC is required.
  
  

Experience (varies By Analyst Level)

• 2+ years performing audits against medical records for correct coding
• Familiarity with the CompIQ Bill Review Platform preferred but not required
• Workers Compensation experience preferred
  
  

What We Offer

CompIQ Solutions provides our full-time, regular team members with the below 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
• Student Debt Solution
• 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
  
  

How To Apply

Interested? Please apply directly via our website at: https://compiqsolutions.com/careers/

CompIQ Solutions is proud to be an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. EOE/M/F/D/V