Medical Bill Auditor

Company Overview

CompIQ Solutions specializes in software and comprehensive services tailored to the property and casualty medical bill review sector. Utilizing proprietary technology and platforms, the company delivers end-to-end solutions focused on three main stakeholders: clients, colleagues, and the company itself.

Role Summary

The Medical Bill Auditor is an integral member of the AuditIQ Bill Review Service Operations team. This position involves conducting detailed, line-level audits on a subset of medical bills handled by Bill Review Operations. The audits assess payment allowances in line with fee schedule guidelines, AMA CPT coding standards, directives from national societies, and overall industry practices.

Key Responsibilities

• Perform comprehensive audits on escalated medical bills to confirm legitimacy and accuracy.
• Evaluate bills for necessary charges and identify unrelated or improper billing.
• Match payment recommendations against fee schedules, regulatory and coding standards, identifying any errors or fraudulent activity.
• Conduct reviews adhering to client-specific rules and internal protocols that may evolve over time.
• Assess provider appeals and disputes to verify if further payments are warranted.
• Contribute to the design and execution of new auditing methodologies aimed at detecting overpayments and underpayments.
• Leverage knowledge of provider billing and patient accounting to uncover additional overpayment recovery possibilities.
• Manage multiple project timelines and ensure compliance with deadlines.
• Achieve targeted savings through thorough auditing of billing documentation.
• Meet daily productivity objectives consistently.
• Effectively communicate findings and audit issues to supervisory personnel.
• Engage in planning sessions, daily team meetings, and backlog reviews.
• Perform other assigned tasks by supervisors and adhere to company policies and code of conduct.

Qualifications

• Associate or Bachelor's degree in Nursing, Medical Coding, Healthcare, or related fields preferred but not mandatory.
• Mandatory Certified Professional Coder (CPC) certification or equivalent from AHIMA or AAPC. Note: CPC-A certification is not acceptable.
• Minimum of 2 years experience auditing medical records for coding accuracy.
• Familiarity with the CompIQ Bill Review Platform is a plus but not required.

Benefits

• Competitive and equitable salary package.
• Flexible work hours with options for hybrid or fully remote work depending on location.
• Generous paid time off policy.
• Paid parental leave benefits.
• Tuition reimbursement opportunities.
• Identity theft protection services.
• Comprehensive medical, dental, and vision insurance plans.
• Company-paid short-term and long-term disability coverage at 100%.
• Fully paid life insurance with additional voluntary enrollment options available.
• Employee assistance programs including up to six free counseling sessions.
• Monthly wellness stipends for gym memberships.
• Health Savings Account (HSA) and Flexible Spending Account (FSA) options.
• 401(k) plan with full company match and immediate vesting.
• Opportunities for career advancement and professional growth.

Equal Opportunity Employer Statement

CompIQ Solutions is committed to equal employment opportunity and considers all qualified applicants without regard to race, color, religion, sex, age, national origin, veteran status, disability, sexual orientation, gender identity, marital status, genetic information, or any other legally protected characteristic.