Durable Medical Equipment Auditor
EXL
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $70,000 - $80,000 per year
About the role
- Review medical records to verify services were provided as billed for Hospital Bill Audit reviews.
- Identify overcharges, undercharges and unbundled items.
- Identify unbundled items on the itemized bill specific to payer Unbundling Guidelines and provide references and rationale to support review findings.
- Onsite Travel – Maintain timely communication with Audit Coordinator regarding scheduling, completion and submission of audits. Abide by the EXL Travel policy while making travel arrangements for onsite audits.
- Scheduling Audits: Manage inventory and schedule audits timely by contacting the provider to schedule date and time to perform audits.
- Report any problems in the audit process to Manager for resolution.
- Comply with HIPAA and other regulations regarding the confidentiality of patient information.
- Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs.
Requirements
- Three or more years of experience in claims processing, medical billing, or auditing—with a strong focus on Durable Medical Equipment (DME).
- In-depth knowledge of HCPCS codes and reimbursement policies.
- Proven ability to read and interpret contract language and fee schedules.
- Intermediate Excel and Word skills, with a solid grasp of basic math.
- Preferably certified with RHIA, CPC, or similar credentials (multiple credentials are a plus).
- Bonus if you’ve used: FACETS, NASCO, Encoder Pro, TrueCode, 3M, Webstrat, Pricers.
- Comfortable working independently in a remote environment.
- Strong written and verbal communication, time management, and analytical skills.
Benefits
- For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingmedical billingauditingDurable Medical Equipment (DME)HCPCS codesreimbursement policiescontract language interpretationfee schedulesExcelWord
Soft Skills
written communicationverbal communicationtime managementanalytical skillsindependent work
Certifications
RHIACPC