Auditor - RCM (US Healthcare)

Role & responsibilities

Patient Estimates/Eligibility Reviewing teams estimates for surgery or other services pre-visit to ensure done correctly The candidate must have a minimum of 3 years of experience in eligibility verification through portals, payer calling, and patient cost estimates.

Billing Reviewing billing work queues, rejections, etc. The candidate must have a minimum of 4 years of experience in billing, clearinghouse rejections, and insurance rejections.

Pre-Cert/Authorizations Review pre-cert requests, denials, notes The candidate must have a minimum of 4 years of experience in requesting authorizations from payers, following up on authorizations with payers, and handling authorization denials.

AR – Review worked accounts and see if the action taken by rep or other third party was appropriate and notated correctly

Preferred candidate profile

Must have 3 to 6 years of experience in end to end RCM cycle and must have worked atleast 2 years in Audting role

Perks and benefits

Pick-up and drop facility as per rules