RCM Auditor

Boomerang Healthcare

Revenue Cycle Management Auditor conducting comprehensive audits in healthcare billing processes. Evaluating charge capture, coding accuracy, and compliance for optimal reimbursement in a remote setting.

Posted 7/14/2026full-timeRemote • Arizona, California, Nevada, New Mexico, Oregon, Texas, Washington • 🇺🇸 United StatesMid-LevelSenior💰 $28 - $33 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in revenue cycle management and auditing within healthcare billing, with a strong focus on compliance, coding accuracy, and process improvement. Proficient in analyzing denial trends and developing targeted education to enhance operational efficiency.

Highest-signal resume keywords

Revenue Cycle ManagementAuditing ExperienceCoding Certification (CPC, CCS)Medicare Billing GuidelinesMicrosoft Excel Proficiency

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Charge Entry AccuracyCPT Coding ComplianceICD-10 Coding ComplianceDenial AnalysisPayment Posting AccuracyQuality AssuranceRoot Cause AnalysisWorkflow ImprovementKPI DevelopmentAutomation Recommendations

Soft Skills

Analytical ThinkingAttention to DetailCommunication SkillsProblem SolvingCollaboration

Tools & Technologies

Audit DashboardMicrosoft Office Applications

Certifications & Qualifications

CPCCCSAAPC CertificationAHIMA Certification

Industry Keywords

Healthcare BillingPain ManagementNCCI EditsPayer-Specific GuidelinesWorkers' Compensation Regulations

About the role

Key responsibilities & impact

Audit execution & oversight by performing routine and ad hoc audits across the full revenue cycle process, including: Charge entry and charge capture accuracy, CPT, HCPCS, and ICD-10 coding compliance, Modifier usage, Workers’ compensation billing rules and state-specific fee schedules, Claim submission accuracy and clean claim rates, Payment posting and adjustment accuracy, AR follow-up effectiveness and denial resolution workflows
Conduct pre-bill and post-bill audits to identify trends impacting reimbursement and compliance
Denial & Revenue leakage analysis: Analyze denial trends across WC, Medicare, and commercial payers, Identify root causes of denials and recommend corrective actions, Quantify revenue impact from: Coding errors, Missed charges, Underpayments, Inefficient workflows
Ensure adherence to: CMS guidelines and Medicare billing requirements, NCCI (CCI edits) and payer-specific edits, State Workers’ Compensation regulations, Documentation standards for pain management procedures
Support internal and external audit readiness (RAC, MAC, payer audits).
Reporting & KPI development through audit dashboard Maintain monthly & quarterly records of all RCM, clinical, and provider audit scores and training requirements
Partner with all BHC teams to develop and deliver targeted education based on audit findings.
Assist in creating and updating SOPs and workflows to reduce errors and improve efficiency
Establish and maintain quality assurance programs across RCM functions
Perform routine QA reviews of staff productivity and accuracy
Recommend automation opportunities and system enhancements
Assumes other responsibilities as appropriate to the position and organizational needs

Requirements

What you’ll need

High school diploma or equivalent required; Associate degree preferred
Active coding certification required: CPC, CCS, or equivalent (AAPC or AHIMA)
5+ years of experience in revenue cycle management
3+ years of auditing experience within healthcare billing or coding
Strong experience in pain management
Experience with Medicare and commercial payer guidelines
Ability to work in a fast-paced environment, meet daily deadlines, and collaborate with cross-functional RCM teams
Excellent communication skills with ability to present findings to providers and RCM leadership
Advanced understanding of NCCI edits and payer-specific billing guidelines
Accuracy and attention to detail, analytical thinking and problem solving and high integrity and compliance focus
Advanced proficiency in Microsoft Excel (e.g., formulas, pivot tables) and solid skills in other Microsoft Office applications

Benefits

Comp & perks

Amazing work/life balance
Generous Medical, Dental, Vision, and Prescription benefits (PPO & HMO)
401(K) Plan with Employer Matching
License & Tuition Reimbursements
Paid Time Off
Holiday Pay & Floating Holiday
Employee Perks and Discount Programs
Supportive environment to help you grow and succeed