Healthcare Audit & Billing Compliance Specialist

IRB Medical Equipment LLC; Grand Blanc (MI); Hybrid; USD 65,000 - 90,000; Full time

Job summary

IRB Medical Equipment LLC is seeking an Audit Specialist to conduct comprehensive audits of billing, documentation, claims, and regulatory compliance across Medicare/Medicaid and commercial payers. You will monitor payer guidelines, validate documentation, and support corrective action plans with cross-functional teams.

Ideal candidates have at least 6 months in healthcare auditing or compliance, strong Excel skills, and experience with DME software; strong communication and analytical abilities

Qualifications

• High school diploma or equivalent.
• Minimum 6 months of experience in healthcare auditing, medical billing, compliance, or DME operations.
• Experience with Medicare, Medicaid, and commercial insurance regulations.
• Experience reviewing medical documentation and insurance claims.

Responsibilities

• Audit patient files, billing records, and clinical documentation.
• Review documentation for compliance with payer standards across Medicare/Medicaid and commercial payers.
• Identify compliance risks and billing vulnerabilities.
• Audit submitted claims for coding accuracy and payer guidelines.
• Prepare audit reports and present findings to management.

Skills

Auditing knowledge

Healthcare compliance

Analytical skills

Attention to detail

Regulatory knowledge

Education

High school diploma

Tools

Brightree

Microsoft Excel

EMR/EHR systems

Job description

IRB Medical Equipment LLC is seeking an Audit Specialist to conduct comprehensive audits of billing, documentation, claims, and regulatory compliance across Medicare/Medicaid and commercial payers. You will monitor payer guidelines, validate documentation, and support corrective action plans with cross-functional teams.

Ideal candidates have at least 6 months in healthcare auditing or compliance, strong Excel skills, and experience with DME software; strong communication and analytical abilities