Remote QA Audit Analyst - DME Billing

ACU-Serve; United States; Remote; USD 52,000 - 70,000; Full time

Job summary

ACU-Serve is seeking a detail-oriented Quality Assurance Audit Analyst to join our remote US team. You will perform quality reviews for pre-pay and post-pay audits, ensure compliance with coding and billing guidelines, and prepare clear management summaries of findings.

You will collaborate with Compliance and internal stakeholders to improve processes, support training, and maintain documentation. Experience with Medicare LCDs and DME billing is required, and strong communication skills are

Qualifications

• Durable Medical Equipment experience is required.
• Must have knowledge of payor requirements for billing, auditing, and/or contracting with a strong background of Medicare LCD requirements; and
• Excellent written and verbal communication skills; and
• Must have knowledge of Word, Excel, and PowerPoint; and
• Demonstrated ability to develop strong business partnerships and relationships with payors; and
• Work closely with other internal customers.

Responsibilities

• Follow defined audit processes in conducting quality reviews;
• Keep current on new coding and billing guidelines, federal and state initiatives.
• Ensure the consistent use of current codes, correct information, documentation and departmental procedures by monitoring their use and identifying any deficiencies;
• Prepare summaries for management of quality review results, including basic analysis of identified deficiencies.
• Reduce quality related errors by making recommendations to increase the efficiency of operations.
• Assist with policy, procedure development and implementation as it relates to the claim review processes.
• Review coding variances including supporting documentation, review of old and new procedure codes, consult and collaborate Director of Compliance as necessary.
• Prepare supporting documentation as necessary.
• Based on audits and claims reviews, prepare supporting documentation requests for configuration changes to ensure that configuration mirrors provider contract.
• Keep current on new coding and billing guidelines, federal and state initiatives. Educate other departments on new/changes to regulations as necessary.
• Coordinate recoupment efforts with Director of Compliance due to billing errors and over payments.
• Respond to provider inquiries regarding recoupments in writing and/or verbally when necessary.
• Perform departmental quality audits.
• Produce and deliver monthly a summary report of changes to the Director of Compliance; include relevant source documents.

Skills

DME billing knowledge

Payor requirements knowledge

Communication skills

Team collaboration

Tools

Word

Excel

PowerPoint

Job description

ACU-Serve is seeking a detail-oriented Quality Assurance Audit Analyst to join our remote US team. You will perform quality reviews for pre-pay and post-pay audits, ensure compliance with coding and billing guidelines, and prepare clear management summaries of findings.

You will collaborate with Compliance and internal stakeholders to improve processes, support training, and maintain documentation. Experience with Medicare LCDs and DME billing is required, and strong communication skills are