Remote Medical Claims Auditor | CPC/CIC Certified

Valenz; Phoenix (AZ); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Medical, Dental, Vision insurance

HSA/FSA/DCFSA

401K with match

Flexible schedule

Paid time off

Employee assistance

Parental leave

Pet insurance

Discount programs

Community giving

Job summary

Valenz is seeking a Clinical Bill Review Analyst to review medical bills, identify discrepancies, and uncover savings opportunities based on standard billing practices and coding guidelines.

You will communicate findings through detailed reports, support discussions with clients, and mentor junior analysts. This fully remote role requires 3+ years in healthcare auditing and CPC/CIC certification with strong CMS knowledge.

Qualifications

• 3+ years of auditing, claims, review, or billing experience within a healthcare organization.
• CPC and/or CIC certification is required for consideration.
• 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 deeper expertise beyond initial review.
• Collaborate with the Negotiation team to resolve complex claim issues and secure additional savings.
• Communicate findings to clients through detailed Bill Review Reports and assist in discussions of bill inquiries.
• Evaluate and respond to bill reconsideration requests, including research or analysis as needed.
• 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, propose system/process improvements, and contribute to policy development.
• Support training efforts by educating internal teams and clients on code changes and bill review procedures.
• Work cross-functionally to implement process efficiencies that improve savings and client satisfaction.
• Ensure compliance with HIPAA and other regulatory standards.
• Perform other duties as assigned.

Skills

Auditing

Claims review

Billing

Communication skills

HIPAA knowledge

Education

CPC/CIC Certification

Tools

RevCycle Pro

Encoder Pro

SuperCoder

Job description

Valenz is seeking a Clinical Bill Review Analyst to review medical bills, identify discrepancies, and uncover savings opportunities based on standard billing practices and coding guidelines.

You will communicate findings through detailed reports, support discussions with clients, and mentor junior analysts. This fully remote role requires 3+ years in healthcare auditing and CPC/CIC certification with strong CMS knowledge.