Audit Specialist

Conducting audits of billing, documentation, insurance claims, and regulatory compliance activities, the full-time Audit Specialist will ensure adherence to Medicare, Medicaid, and commercial insurance requirements while identifying opportunities for improving reimbursement accuracy and reducing audit risk. Key responsibilities Perform routine and targeted audits of patient files and billing records to ensure compliance with payer standards Audit submitted claims for coding accuracy and collaborate with billing staff to resolve discrepancies Prepare audit reports outlining findings and assist in developing policies to strengthen compliance Required qualifications High school diploma or general education degree Minimum of 6 months of experience in healthcare auditing, medical billing, or compliance Experience with Medicare, Medicaid, and commercial insurance regulations Strong understanding of DMEPOS billing requirements and audit methodologies Advanced proficiency in Microsoft Excel and reporting tools