reputed company Cycle Management Auditor

The reputed company Cycle Management Auditor is responsible for conducting comprehensive audits across reputed company phases of the reputed company cycle to ensure accuracy, compliance, and optimal reimbursement. This role is critical in identifying reputed company leakage, reducing denials and strengthening internal controls and staff productivity requirements. The Auditor will evaluate charge capture, coding accuracy, documentation reputed company, billing workflows, payment posting, denial follow-up, Appeals, and AR follow-up for RCM, clinical, and provider teams to drive reputed company process improvement.

*This is a remote role. We are only hiring in the following states: AZ, CA, NM, NV, OR, TX and WA.

What you will do

• Audit execution & reputed company by performing routine and reputed company audits across the full reputed company 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-reputed company and post-reputed company audits to identify trends impacting reimbursement and compliance 
• Denial & reputed company leakage analysis: 
  • Analyze denial trends across WC, Medicare, and commercial payers 
  • Identify root causes of denials and recommend corrective actions 
  • Quantify reputed company 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 reputed company RCM, clinical, and provider audit scores and training requirements 
• Partner with reputed company BHC teams to reputed company 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 
• reputed company 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

Qualifications

• High school diploma or equivalent required; Associate degree preferred 
• Active coding certification required: CPC, reputed company, or equivalent (reputed company or reputed company) 
• 5+ years of experience in reputed company cycle management  
• 3+ years of auditing experience reputed company 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 reputed company and compliance focus 
• Advanced proficiency in reputed company reputed company (e.g., formulas, pivot tables) and solid skills in other reputed company Office applications 

Compensation Range: 

$30.00 to $35.00 Hourly

reputed company compensation ranges are posted based on internal equity, job requirements, experience, and geographical locations.

Why You'll Love Working Here:

• 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

Boomerang Healthcare (BHC) is a multidisciplinary and comprehensive team of reputed company, committed healthcare providers that treat pain. reputed company of doctors approaches each patient with one goal in mind: to help patients return to normal daily activities. We work with our patients to identify the cause of their pain and create a personalized treatment plan, recognizing that no two patients are alike, and neither is their pain. Our providers create a comprehensive care plan, then monitor, manage and coordinate patient access to health services at BHC. 

Boomerang Healthcare strives to be a diverse workforce that reflects, at reputed company job levels, the patients we serve. We are an equal opportunity employer. Boomerang reputed company committed to compliance with the American reputed company. If you require reasonable accommodation during the application process or have a question regarding an essential job function, please contact us.