Auditor (Medical)

AUDITOR (MEDICAL) 

Location:   80 Marcus Drive Melville, New York   11747

Growing Healthcare Receivable Management Company seeks detail-oriented full-time Auditor/Analyst with a medical background in medical/hospital billing and coding to Analyze and follow up on patient accounts.  Experience with Health Insurances is preferred.

Summary of Responsibilities:

• Follow up and analysis on hospital patient accounts, including follow up with third party payers

Responsibilities:

• Review/Analyze Physician/Outpatient accounts to determine issues causing denial or delay of payment.
• Review denials related to ICD-10 and CPT code denials
• Review medical necessity denials due to lack of documentation/insufficient coding.
• Submit written claim/payment disputes as necessary.
• Prepare and submit appeals for authorization denials/administrative denials as necessary.
• Follow up on status for Outpatient/Physician claims and/or denials.
• Communicate with other departments in order to have accounts reviewed and obtain additional information needed to dispute claims issues as needed.