Licensed Medicare Audit Specialist
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Priority Claims Specialist IV -
Remote.
Key Responsibilities
Review complex claims and patient records, identifying
discrepancies in payments to Medicare providers
Prepare complex claims reimbursement submissions and serve as an
advocate for clinic administration regarding reimbursement
issues
Conduct analytical research on pricing, reimbursement, and claim
appeals processes while maintaining relationships with insurance
organizations
Required Qualifications
High school education or equivalent
6 years of experience with payor policies, reimbursement, and
medical policy
Bachelor's degree preferred
Licensed Medicare auditor or Certified Medical Audit Specialist
preferred
High-level knowledge of Medicare audit, appeals, and reimbursement
processes
Keywords: VirtualVocations, Victorville , Licensed Medicare Audit Specialist, Accounting, Auditing , Vista, California
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