Claims Auditor & Billing Specialist

Job Title: Claims Auditor & Billing Specialist

Job Type: Full-Time, Remote

Working Hours: US Hours (9am-5pm EST)

Key Responsibilities

• Conduct front-end audits of claims prior to submission to identify errors, inconsistencies, or missing information
• Review documentation, scheduling data, authorizations, and payer requirements to research and resolve discrepancies
• Communicate with providers and internal teams to verify services delivered and ensure accurate claim representation
• Make corrections and updates within the practice management system to produce clean, submission-ready claims
• Apply payer-specific and state-specific billing rules to ensure compliance and minimize denials
• Interpret and apply billing regulations to resolve new or complex scenarios effectively
• Review Explanation of Benefits (EOBs), Electronic Remittance Advice (ERA), and bank deposits to accurately post payments
• Reconcile posted payments against deposit totals and investigate discrepancies or underpayments
• Identify and escalate payer trends, issues, or inconsistencies
• Generate and update patient invoices as needed
• Follow up with patients or responsible parties on outstanding balances
• Document all communication attempts and payment arrangements
• Support timely resolution of accounts receivable to improve overall 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/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

Benefits:
• Comfortable working U.S. hours
• Remote work from home

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