Claims Auditor & Billing Specialist

17 hours, 54 minutes ago
Full-time
Mid Level
Operations
Reworks Solutions

Reworks Solutions

ReWorks Solutions provides rigorously vetted, native English-speaking remote professionals backed by white-glove management and proactive support.

Internet Software & Services

Description

  • Conduct front-end audits of claims before submission to identify errors, inconsistencies, and missing information.
  • Review documentation, scheduling data, authorizations, and payer requirements to resolve claim discrepancies.
  • Communicate with providers and internal teams to verify services delivered and ensure accurate claim representation.
  • Make corrections and updates in the practice management system to produce clean, submission-ready claims.
  • Apply payer-specific and state-specific billing rules to support compliance and reduce denials.
  • Interpret billing regulations to resolve new or complex billing scenarios.
  • Review EOBs, ERAs, and bank deposits to post payments accurately.
  • Reconcile posted payments against deposit totals and investigate discrepancies or underpayments.
  • Identify and escalate payer trends, issues, or inconsistencies.
  • Generate and update patient invoices, follow up on outstanding balances, and document payment arrangements.
  • Support timely resolution of accounts receivable to improve financial performance.

Requirements

  • Experience with medical billing, claims auditing, or revenue cycle management.
  • Strong understanding of payer requirements, billing compliance, and claims processes.
  • Ability to interpret and apply billing rules across multiple payers and states.
  • Experience reviewing EOBs and ERAs and posting payments accurately.
  • Proven ability to reconcile payments and identify discrepancies.
  • Strong attention to detail and problem-solving skills.
  • Excellent communication skills for collaborating with providers and internal teams.
  • Ability to work independently and manage high-volume workflows.
  • Comfortable working US hours (9am-5pm EST).

Benefits

  • Remote work from home.
  • Full-time role.
  • Comfortable working U.S. hours (9am-5pm EST).
  • Fraud protection notice: official communication will only come from a ReWorks Solutions email address.

Interested in this position?

Apply directly on the company website

Apply Now

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