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RCM Audit Specialist

Revenue Cycle Solutions, LLC -
Remote

Quick Apply

Job Details

Full-time
14 days ago

Benefits

Health savings account
Paid holidays
Health insurance
Dental insurance
Paid time off
Work from home
Vision insurance
401(k) matching
Flexible schedule
Paid sick time

Qualifications

Revenue cycle management
Accounts receivable
Operational analysis
Audit Reporting
Medical billing
Data analytics
Medical accounts receivable management
Root cause analysis
Process management
Analytics

Full Job Description

Job Summary

About This Role:

The Audit Specialist is a high-impact, analytical role designed for a Revenue Cycle Management (RCM) strategist who thrives at the intersection of process optimization and regulatory compliance.

At RCS, we don’t just "look at files"—we safeguard the financial and operational integrity of our systems. As an Audit Specialist, you are a vital cross-functional investigator, analyzing claim data to identify patterns, trends, and root causes of revenue leakage and denials, while transforming those findings into actionable process improvements that optimize revenue capture.

Job description:

Under the direction of the Director of Implementation & Operational Development, the Audit Specialist plays a crucial role in ensuring the accuracy, efficiency, and compliance of the revenue cycle process. This position involves conducting audits of medical claims, identifying areas for improvement, and providing recommendations to optimize revenue capture and reduce denials. The Audit Specialist will work closely with various departments to improve processes and ensure compliance with industry regulations and payer requirements.

This position is fully remote.

Flexible hours. Create your own daily work days. Must be within operating hours of 7am to 7pm EST.

Join our team as an Audit Specialist where your analytical precision and mastery of revenue integrity will contribute significantly to the financial excellence of our clients through the strategic identification of revenue leakage and the delivery of data-driven process optimizations.

About Revenue Cycle Solutions, LLC (RCS):

RCS is a leading provider of revenue cycle management solutions for healthcare organizations. We are committed to delivering exceptional service and innovative solutions that help our clients optimize their revenue cycle processes, improve financial performance, and enhance patient satisfaction. We value our employees and strive to create a positive and supportive work environment where everyone can thrive.

Our Mission Statement:

Collect as much as client structure allows
Collect as quickly as possible
Complete numbers 1 and 2 as efficiently as possible

Responsibilities:

Educate and promote RCS’s 3 objectives
Conduct thorough AR audits of all claims over 30 days for each client to ensure accuracy of payments, denials and internal billing processes
Analyze audit findings to identify patterns, trends, and root causes of errors, denials, and revenue leakage.
Analyze processes for Account Receivable, Claim Submission, and Payment Posting to ensure accuracy completeness, identify and document any discrepancies and errors
Communicate audit findings to the Director of Implementation & Operational Development, with particular attention given to any detriment and training issues discovered.
Provide recommendations or feedback for corrective actions and process improvements to enhance revenue cycle performance and minimize denials.
Audit assignments are to be completed as quickly, efficiently and accurately as possible each month
Maintain current knowledge of billing regulations, payer requirements, and industry best practices.
Prepare reports summarizing audit findings, trends, and recommendations for management review.
Requires the ability to navigate external platforms beyond RCS when necessary
Log PDS daily and accurately
Perform other related duties as assigned.

Expectations:

Maintain high accuracy and attention to detail
Meet deadlines and productivity goals
Proactively identify issues and solutions
Maintain Employee/Management/Client Confidentiality
Promote and maintain Team Vitality within and between teams
Become proficient in all assigned platforms used by RCS as pertains to role
Provide clear and concise communication

Benefits:

Health Insurance: Medical, Dental, Vision
Health Savings Account (HSA)
Work from home
Flexible schedule
Paid time off (PTO)
Paid sick leave
Paid Holidays
401(k)
ZayZoon
Remote Workspace Enhancement Program

Requirement:

Revenue cycle management: 3 years (Required)
Current or most recent role must be an Audit Specialist or similar (Required)
Authorized to work in the United States (Required)
Experienced with provider specialities:
Physical Therapy: 1 year (Preferred)
Pain Management: 1 year (Preferred)
Internal Medicine: 1 year (Preferred)

Job Type: Full-time

Expected hours: 40 per week

Schedule:

8 hour shift
Monday to Friday
Choose your own hours within operating window (7AM-7PM EST)

Benefits:

401(k) matching
Dental insurance
Flexible schedule
Health insurance
Health savings account
Paid time off
Vision insurance

Application Question(s):

Are you a U.S. Citizen? (Note: Proof of citizenship, such as a U.S. Passport or U.S. Birth Certificate, is required for this role.)
What state do you live in?
What is your email address?
What is your current or most recent role title?

Experience:

RCM Audit Analyst : 3 years (Required)
Medical billing: 2 years (Required)
RCM Accounts Receivable: 2 years (Required)
RCM : 1 year (Preferred)

Work Location: Remote

Quick Apply

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