Remote CPC/CIC Bill Review Analyst – Claims Auditor

Valenz; United States; Remote; USD 60,000 - 85,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

HSA

FSA

DCFSA

401K with company match

Flexible working

Paid Time Off

Employee Assistance Program

Maternity/Paternity leave

Pet insurance

Employee discounts

Community giveback

Job summary

Valenz is seeking a Clinical Bill Review Analyst to audit medical bills, identify billing and coding discrepancies, and uncover savings opportunities for our clients. You’ll deliver detailed reports, communicate findings, and mentor junior analysts while ensuring HIPAA compliance.

Remote work is fully supported from anywhere in the US, with equipment provided. Ideal candidates have CPC or CIC, 3+ years in healthcare auditing, and strong knowledge of ICD-10, CPT, and CMS guidelines.

Qualifications

• 3+ years of auditing, claims, review and/or billing experience within a healthcare organization.
• Excellent communication skills, both verbal and written.
• Working knowledge of industry coding, ICD-10, CPT, HCPCS Revenue codes etc.
• CPC and/or CIC certification
• 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 discuss complex bill-related inquiries.
• Evaluate and respond to bill reconsideration requests, including those requiring 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.
• Assist in identifying trends in billing issues, proposing system/process improvements, and contributing to policy development.
• Support training efforts by educating internal teams and clients on changes to codes, edits, and bill review procedures.
• Work cross-functionally with internal teams to identify and implement process efficiencies that improve savings and client satisfaction.
• Ensure compliance with HIPAA and other regulatory standards.
• Perform other duties as assigned.

Job description

Valenz is seeking a Clinical Bill Review Analyst to audit medical bills, identify billing and coding discrepancies, and uncover savings opportunities for our clients. You’ll deliver detailed reports, communicate findings, and mentor junior analysts while ensuring HIPAA compliance.

Remote work is fully supported from anywhere in the US, with equipment provided. Ideal candidates have CPC or CIC, 3+ years in healthcare auditing, and strong knowledge of ICD-10, CPT, and CMS guidelines.