Durable Medical Equipment Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Examine medical records to confirm that services were rendered as billed for Hospital Bill Audit reviews.

• Detect overcharges, undercharges, and unbundled items.

• Identify unbundled items on detailed bills following payer Unbundling Guidelines, providing references and rationale to support findings.

• Maintain prompt communication with the Audit Coordinator regarding scheduling, completion, and submission of audits.

• Adhere to EXL Travel policy when organizing travel for onsite audits.

• Oversee audit inventory and schedule audits by reaching out to providers.

• Report any issues in the audit process to the Manager for resolution.

• Ensure compliance with HIPAA and other regulations governing patient-information confidentiality.

• Execute job functions following company Compliance, Information Security, and Regulatory policies and procedures.

⛳️ Requirements

• Minimum of three years of experience in claims processing, medical billing, or auditing, with a strong emphasis on Durable Medical Equipment (DME).

• Comprehensive knowledge of HCPCS codes and reimbursement policies.

• Capability to read and interpret contract language and fee schedules.

• Intermediate skills in Excel and Word.

• Strong understanding of basic math principles.

• RHIA, CPC, or similar credentials are preferred.

• Experience with FACETS, NASCO, Encoder Pro, TrueCode, 3M, Webstrat, or Pricers is advantageous.

• Comfortable working independently in a remote setting.

• Excellent written and verbal communication, time management, and analytical skills.

🏝️ Benefits

• Fully remote opportunity / work from anywhere in the U.S.

• Up to 10% travel may be required.