PFS Auditor, Remote

Compensation $30.00 - $35.00 an hour per year. You are eligible for a Short-Term Incentive Plan with the target at 5% of your annual earnings; terms and conditions apply. Patient Financial Services – Auditor, Remote The PFS Auditor works with PFS management, attorneys and claims representatives by reviewing and appealing claims when appropriate to overturn clinical validation and coding denials from Medicare, Medicaid, and other third-party payers. Essential Functions • Conducts SOX reviews by assessing internal controls and auditing billing processes • Conducts pre and post billing reviews to ensure quality standards are met prior to billing. Completes assignments in a manner that meets the quality assurance goal of 100% accuracy. • Monitors the results of claims audit policies and procedures and reports findings to appropriate leadership. • Utilizes Medicare and Contractor guidelines for coverage determinations. Utilizes extensive knowledge of medical terminology, ICD-10-CM, HCPCS Level II to conduct audits. • Participate in pre- & post-review meetings, providing support and recommendations for issues presented. Ensure past review recommendations are implemented in current review process. • Provides a broad-based knowledge in billing and collections, strong knowledge of industry practice and business principles to ensure department is compliant with all billing practices • Works in partnership with other departments for education on patient billing policies and process improvements • Other duties as assigned Qualifications • CPC or CPMA preferred • Associates degree preferred • Knowledge of CPT codes, medical terminology, insurance plans, ICD 10 codes • Utilizes Medicare and Contractor guidelines for coverage determinations. Utilizes extensive knowledge of medical terminology, ICD-10-CM, HCPCS Level II to conduct audits. • Must have ability to adapt to a fast paced, dynamic environment PRIVACY NOTICES To review Ambry’s Privacy Notice, Click here: https://www.ambrygen.com/legal/privacy-policy To review the California privacy notice, click here: California Privacy Notice | Ambry Genetics To review the UKG privacy notice, click here: California Privacy Notice | UKG Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. Apply tot his job Apply To this Job