Senior Itemized Bill Review Auditor (Remote)

AAPC; United States; Remote; USD 60,000 - 86,000; Full time

Benefits offered by this job

401(k) employer match

Comprehensive health benefits

Generous vacation policy

Educational assistance

Job summary

Gainwell Technologies is seeking a Lead Associate for Itemized Bill Review Quality Auditor, remote within the United States. The role focuses on audits of medical records, UB-04 forms, and claims to ensure accuracy, regulatory compliance, and proper billing practices.

You will act as SME in hospital billing, guide staff, and support training while maintaining up-to-date knowledge of revenue codes, CPT/HCPCS, and CMS guidelines. This is a remote, full-time opportunity with growth potential.

Qualifications

• Certified Coder or RN with Coding Experience preferred.
• 5+ years Itemized Bill Review or Hospital Bill Audit experience.
• Experience auditing high-dollar institutional claims.
• Expert knowledge of ICD-10 Coding Guidelines and UB-04 billing.

Responsibilities

• Perform quality audits of itemized bill reviews to ensure accuracy and compliance.
• Validate audit findings by reviewing bills, medical records, claims, and supporting docs.
• Identify payment integrity opportunities and mentor junior reviewers.

Skills

Quality auditing

Hospital billing

CMS reimbursement

NCCI edits

Regulatory compliance

Education

Associate degree (Health Information Management / Nursing / Healthcare Administration / Business Administration)

Tools

RAPS or coding knowledge

Job description

Gainwell Technologies is seeking a Lead Associate for Itemized Bill Review Quality Auditor, remote within the United States. The role focuses on audits of medical records, UB-04 forms, and claims to ensure accuracy, regulatory compliance, and proper billing practices.

You will act as SME in hospital billing, guide staff, and support training while maintaining up-to-date knowledge of revenue codes, CPT/HCPCS, and CMS guidelines. This is a remote, full-time opportunity with growth potential.