Role Overview
The Audit Specialist is a remote, analytical role focused on improving revenue integrity, compliance, and operational efficiency within healthcare revenue cycle processes. Reporting to the Director of Implementation & Operational Development, this role analyzes medical claims and AR data to identify trends, root causes of denials, and revenue leakage, and translates findings into actionable process improvements.
Key Responsibilities
- Conduct AR audits for claims aged 30+ days across client accounts
- Identify patterns, trends, and root causes of denials and revenue leakage
- Review AR, claims submission, and payment posting processes for accuracy and compliance
- Prepare audit reports with findings, trends, and recommendations
- Communicate insights and issues to leadership, including training and process gaps
- Recommend and support process improvements to optimize revenue cycle performance
- Maintain knowledge of payer rules, billing regulations, and industry standards
- Use internal and external platforms to complete audit work
- Maintain accurate daily documentation and reporting (PDS logs)
- Collaborate with cross-functional teams and support assigned duties
Requirements
- 3+ years in Revenue Cycle Management (required)
- 3+ years’ experience as a medical data analyst or similar analytical role (required)
- Current or recent experience as an Audit Specialist or similar role (required)
- Experience with provider specialties such as Physical Therapy, Pain Management, or Internal Medicine (preferred)
- High school diploma or GED (minimum education)
- Authorized to work in the U.S.
- Strong analytical, communication, and problem-solving skills
Benefits
- Medical, dental, and vision insurance
- Health Savings Account (HSA)
- Paid time off, sick leave, and holidays
- 401(k)
- Remote work setup support program
- Flexible scheduling
- Additional employee wellness benefits
Core Expectations
- High accuracy and attention to detail
- Ability to meet deadlines and productivity targets
- Strong confidentiality and compliance adherence
- Clear, professional communication
- Proactive identification of issues and improvements
- Strong collaboration across teams
Additional Details
- 8-hour shifts within operating window (7 AM–7 PM EST)
Pay: $18.00 - $20.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Flexible schedule
- Health insurance
- Health savings account
- Paid time off
- Relocation assistance
- Vision insurance
Work Location: Remote
