Position Summary:

The Billing Quality Auditor is responsible for ensuring all billable services are accurately
captured, transmitted, and accepted throughout the revenue cycle. This position monitors billing
workflows, identifies revenue leakage, reconciles claims throughout the billing process, and
resolves exceptions before they result in denials or lost revenue. .

Schedule: Monday - Friday, 8:00 AM - 4:00 PM AZ Time; Full-time, 40 work hours per week (with 30 mins paid break)

Requirements:

 ● Experience with excel and google sheets
● Good communication skills
● Time Management skills
● Detail oriented
● Insurance claims experience 

Primary Responsibilities

Billing Quality Assurance
● Audit claims prior to submission for completeness and accuracy.
● Verify claims successfully transmit from the EHR to the RCM and clearinghouse.
● Monitor rejected claims and transmission errors.
● Identify duplicate or missing claims.
● Ensure all eligible services are billed.

Revenue Reconciliation
● Reconcile schedules, documentation, charges, and submitted claims.
● Compare daily census against billable encounters.
● Identify missing charges and missed billing opportunities.
● Verify claims are accepted by payers.

Exception Management
● Manage billing exception queues.
● Investigate claim transmission failures.
● Monitor timely filing deadlines.
● Escalate system issues when appropriate.

Quality Improvement
● Develop billing quality reports and dashboards.
● Identify trends affecting claim acceptance.
● Recommend workflow improvements.
● Assist with implementation of billing process enhancements.

Daily Responsibilities
● Review daily billing reports.
● Monitor claim transmission status.
● Audit claim batches before submission.
● Reconcile encounters against submitted claims.
● Review clearinghouse acknowledgments.
● Resolve transmission errors.
● Report revenue leakage opportunities.
● Track outstanding billing exceptions.
● Correct Transmission errors.