Billing Auditor

Altea Healthcare; Gilbert (AZ); Hybrid; USD 60,000 - 90,000; Full time

Job summary

Altea Healthcare in Gilbert, AZ, is seeking a Billing Auditor to perform comprehensive audits of revenue cycle billing activities, ensuring accuracy, completeness, and compliance of claims submitted for reimbursement.

The role serves as a QA resource within Revenue Cycle Management, identifying billing errors, documentation deficiencies, coding inconsistencies, workflow opportunities, and compliance risks. Hybrid work arrangement in Gilbert.

Qualifications

• 3+ years healthcare revenue cycle experience.
• Billing audit or QA experience preferred.
• Knowledge of Medicare, Medicaid, and commercial billing.
• Strong analytical and communication skills.
• Knowledge of CPT, HCPCS, ICD-10-CM preferred.
• Attention to detail and data trend identification.

Responsibilities

• Performs routine and targeted audits of billing activities.
• Reviews claims for accuracy, documentation, coding, modifiers, and payer compliance.
• Identifies billing errors, denial trends, workflow deficiencies, and compliance risks.
• Conducts retrospective and prospective audits.
• Provides audit reports and performance metrics.
• Monitors Medicare, Medicaid, and commercial payer compliance.
• Reviews adjustments and write-offs.
• Assists with quality standards and SOP development.
• Participates in process improvement.
• Performs other duties as assigned.

Skills

Billing audits

Healthcare revenue cycle

Data analysis

Strong communication

CPT/HCPCS knowledge

Tools

Microsoft Office

Billing software

Job description

Department: Revenue Cycle Management (RCM)

Location: Gilbert, AZ; Hybrid

Position Summary

The Billing Auditor performs comprehensive audits of revenue cycle billing activities to ensure the accuracy, completeness, and compliance of claims submitted for reimbursement.

This role serves as a quality assurance resource within the Revenue Cycle Management department by identifying billing errors, documentation deficiencies, coding inconsistencies, workflow opportunities, and compliance risks.

Key Responsibilities

• Performs routine and targeted audits of billing activities.
• Reviews claims for accuracy, documentation, coding, modifiers, and payer compliance.
• Identifies billing errors, denial trends, workflow deficiencies, and compliance risks.
• Conducts retrospective and prospective audits.
• Provides audit reports and performance metrics.
• Monitors Medicare, Medicaid, and commercial payer compliance.
• Reviews adjustments and write-offs.
• Assists with quality standards and SOP development.
• Participates in process improvement.
• Performs other duties as assigned.

Qualifications

• Proficient in Microsoft Office and billing software.
• 3+ years healthcare revenue cycle experience.
• Billing audit or QA experience preferred.
• Knowledge of Medicare, Medicaid, and commercial billing.
• Strong analytical and communication skills.
• Knowledge of CPT, HCPCS, ICD-10-CM preferred.
• Attention to detail.
• Data analysis and trend identification.