[Hiring] Claims Auditor & Billing Specialist @ReWorks Solutions

Role Description

• Conduct front-end audits of claims prior to submission to identify errors, inconsistencies, or missing information.
• Review documentation, scheduling data, authorizations, and payer requirements to research and resolve discrepancies.
• Communicate with providers and internal teams to verify services delivered and ensure accurate claim representation.
• Make corrections and updates within the practice management system to produce clean, submission-ready claims.
• Apply payer-specific and state-specific billing rules to ensure compliance and minimize denials.
• Interpret and apply billing regulations to resolve new or complex scenarios effectively.
• Review Explanation of Benefits (EOBs), Electronic Remittance Advice (ERA), and bank deposits to accurately post payments.
• Reconcile posted payments against deposit totals and investigate discrepancies or underpayments.
• Identify and escalate payer trends, issues, or inconsistencies.
• Generate and update patient invoices as needed.
• Follow up with patients or responsible parties on outstanding balances.
• Document all communication attempts and payment arrangements.
• Support timely resolution of accounts receivable to improve overall financial performance.

Qualifications

• Experience with medical billing, claims auditing, or revenue cycle management.
• Strong understanding of payer requirements, billing compliance, and claims processes.
• Ability to interpret and apply billing rules across multiple payers and states.
• Experience reviewing EOBs/ERAs and posting payments accurately.
• Proven ability to reconcile payments and identify discrepancies.
• Strong attention to detail and problem-solving skills.
• Excellent communication skills for collaborating with providers and internal teams.
• Ability to work independently and manage high-volume workflows.
• Comfortable working U.S. hours.

Requirements

• Remote work from home.

Benefits

• Fraud Disclaimer: ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.