Revenue Cycle Auditor: Optimize Billing & Claims

Stance Health Solutions, Inc; California (MO); On-site; USD 60,000 - 90,000; Full time

Job summary

Stance Health Solutions, Inc is seeking a Revenue Cycle Auditor to manage the revenue cycle, submit claims, and analyze denials. You will work with payers and internal teams to improve cash flow and ensure HIPAA-compliant processes. Strong analytical skills and Excel experience are required.

Responsibilities include reviewing claims, auditing accounts, coordinating with providers, and reporting on KPIs to drive improvements in denial rates and time to payment.

Qualifications

• Minimum 2 years’ experience in Revenue Cycle Management.
• High school diploma or equivalent required.
• Effective verbal and written skills.
• Knowledge of insurance carrier guidelines and claims processing guidelines.
• Understanding healthcare regulations, coding guidelines, and payer policies.
• Able to work in a fast-paced environment with adaptability.
• Strong communication and organizational skills for payer audits.
• Proficiency with Microsoft Excel.
• Experience with Brightree EHR or other EHR system.
• Knowledge of MS Office.
• Analytical and problem-solving abilities.
• Precision in reviewing documents and data.

Responsibilities

• Process and submit insurance claims to various payers, ensuring accuracy in coding and billing information to minimize denials and delays.
• Review patient accounts to verify correct insurance billing information, update records as necessary, and resolve discrepancies.
• Analyze denied claims to identify denial reasons and perform follow-up actions with documentation.
• Analyze accounts receivable reports and resolve repetitive denials.
• Coordinate with healthcare providers to obtain necessary medical documentation, referrals, or authorizations.
• Engage with payers to address aging balances and optimize cash flow.
• Monitor key performance indicators related to revenue cycle activities and identify improvement opportunities.
• Support QA, reviews and huddles with global partners and internal teams.

Skills

Interpersonal skills

Communication skills

Time management

Organizational skills

Analytical skills

Problem-solving

Attention to detail

Education

High School Diploma or equivalent

Tools

Microsoft Excel

Brightree EHR

Job description

Stance Health Solutions, Inc is seeking a Revenue Cycle Auditor to manage the revenue cycle, submit claims, and analyze denials. You will work with payers and internal teams to improve cash flow and ensure HIPAA-compliant processes. Strong analytical skills and Excel experience are required.

Responsibilities include reviewing claims, auditing accounts, coordinating with providers, and reporting on KPIs to drive improvements in denial rates and time to payment.