Remote Clinical Billing Audit Specialist

Vālenz Health; Northern (KY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Fully remote position

Medical, Dental & Vision insurance

401K with company match

Generous PTO and paid holidays

HSA / FSA

Job summary

Valenz Health is seeking a Clinical Bill Review Analyst to review claims, identify billing discrepancies, and uncover savings opportunities across client portfolios. You will work with internal teams to resolve complex issues, prepare detailed reports, and ensure compliance with coding guidelines and HIPAA standards.

The role emphasizes strong communication, problem-solving, and attention to detail, with opportunities to mentor junior analysts and influence process improvements within a fully

Qualifications

• 3+ years of auditing, claims review, or billing experience within a healthcare organization.
• CPC and/or CIC certification.
• Working knowledge of ICD-10, CPT, HCPCS Revenue codes etc.
• Excellent communication skills, both verbal and written.
• Knowledge of CMS guidelines.

Responsibilities

• Review medical bills to identify appropriate billing, coding, and savings opportunities.
• Analyze and resolve claim discrepancies that require a deeper level of expertise beyond initial review.
• Collaborate with the Negotiation team to resolve more complex claim issues and secure additional savings.
• Communicate findings to clients through detailed Bill Review Reports and assist in discussing complex bill-related inquiries.
• Evaluate and respond to bill reconsideration requests with additional research or analysis.
• Handle escalated provider inquiries, resolve disputes, and conduct direct negotiations for billing discrepancies.
• Provide guidance and mentor junior analysts in claim review best practices.
• Identify trends in billing issues and contribute to policy development and process improvements.
• Support training efforts by educating internal teams and clients on changes to codes, edits, and bill review procedures.

Skills

Auditing

Claims review

Communication skills

CMS guidelines

HIPAA knowledge

Education

CPC certification

CIC certification

Tools

RevCycle Pro

Encoder Pro

SuperCoder

Job description

Valenz Health is seeking a Clinical Bill Review Analyst to review claims, identify billing discrepancies, and uncover savings opportunities across client portfolios. You will work with internal teams to resolve complex issues, prepare detailed reports, and ensure compliance with coding guidelines and HIPAA standards.

The role emphasizes strong communication, problem-solving, and attention to detail, with opportunities to mentor junior analysts and influence process improvements within a fully