Remote Medical Billing QA Specialist

Sarnova; United States; Remote; USD 42,000 - 64,000; Full time

Benefits offered by this job

Daily Drop

Course discount

Job summary

Digitech, part of the Sarnova family, seeks a QA Specialist to ensure Medicare/Medicaid claims are accurate before submission. This remote, full-time role requires reviewing PCRs, validating service levels, and confirming payer rules in a high-volume billing environment.

You will collaborate with Coding, Billing, and QA teams to resolve questions, maintain documentation standards, and identify trends for continuous improvement. A high school diploma is required; clinical background preferred.

Qualifications

• High school diploma or equivalent required.
• Clinical or medical background preferred.
• Strong understanding of medical terminology and billing standards.

Responsibilities

• Perform detailed quality reviews of Medicare/Medicaid claims after coding and before submission to ensure accuracy and compliance.
• Examine PCRs to confirm documentation supports billed level of service and adheres to payer rules.
• Validate coding selections, including level of service assignments and required clinical indicators.
• Ensure documentation compliance with federal, state, and payer regulations including signatures and narratives.
• Verify claim readiness by ensuring all documentation and attachments are present before release.
• Identify discrepancies or errors and escalate or return claims to coders for review.

Skills

Medical terminology

PCR review

Regulatory compliance

Remote work

Attention to detail

Time management

Education

High School Diploma or equivalent

Job description

Digitech, part of the Sarnova family, seeks a QA Specialist to ensure Medicare/Medicaid claims are accurate before submission. This remote, full-time role requires reviewing PCRs, validating service levels, and confirming payer rules in a high-volume billing environment.

You will collaborate with Coding, Billing, and QA teams to resolve questions, maintain documentation standards, and identify trends for continuous improvement. A high school diploma is required; clinical background preferred.