Remote Claims Audit Lead – Revenue Cycle

Cardinal Health; Sacramento (CA); Remote; USD 69,000 - 88,000; Full time

Benefits offered by this job

Medical, dental and vision

Paid time off

Health savings account

401k plan

Early wage access

Flexible spending accounts

Short- and long-term disability

Work-Life resources

Paid parental leave

Healthy lifestyle programs

Job summary

Cardinal Health is seeking an experienced professional to lead Revenue Cycle Management audits. You will oversee the Audit team, ensure QA/QI processes, and respond to audit requests for TPE, CERT, RAC, and other reviews.

You will compile documentation, coordinate actions with colleagues, and ensure timely communications with payers and regulators. The role emphasizes adherence to Federal and State regulations, accuracy in clinical documentation reviews, and continuous improvement of audit

Qualifications

• 4-8 years of experience in related field, preferred
• Leadership or supervisory experience preferred
• Urology or wound care product knowledge preferred

Responsibilities

• Oversee Audit team and respond to audit requests timely
• Focus on quality assurance and compliance per Federal and State regulations
• Lead reviews of clinical documentation for accuracy and compile audit responses
• Coordinate with team to complete tasks to high standards
• Provide monthly feedback on audits, recoupment inquiries, and policy issues
• Manage all aspects of a TPE, CERT, RAC, pre/post payment audits and responses
• Oversee recoupment or refund requests and respond within timeframes
• Monitor and trend audits; gather and review documentation for audits
• Maintain communication with CMS and other auditors
• Stay up to date on Medicare updates and trainings
• Perform other duties as assigned

Skills

Leadership

Project management

Supervisory experience

Healthcare product knowledge

Education

Bachelor's degree or equivalent

Job description

Cardinal Health is seeking an experienced professional to lead Revenue Cycle Management audits. You will oversee the Audit team, ensure QA/QI processes, and respond to audit requests for TPE, CERT, RAC, and other reviews.

You will compile documentation, coordinate actions with colleagues, and ensure timely communications with payers and regulators. The role emphasizes adherence to Federal and State regulations, accuracy in clinical documentation reviews, and continuous improvement of audit