Auditor for Medical Billing and Credentialing

2 days ago


Rawalpindi Cantonment, Pakistan Meds Nexus Private Limited Full time

As a key member of our team, you will be responsible for ensuring the accuracy and integrity of our medical billing and credentialing processes.

Key Responsibilities:

  • Audit Planning and Execution: Conduct regular audits on charge entries, payment postings, and claim submissions to ensure compliance with industry standards and company policies.
  • Compliance and Regulatory Adherence: Ensure all billing and credentialing activities comply with relevant regulations, including HIPAA and CMS guidelines.
  • Consulting and Mentorship: Provide consulting services and lead independent audits and assessments to improve operations and manage risks related to complex technology and processes.
  • Performance Analysis and Reporting: Prepare and deliver KPI & MTD reports to track performance and resolve discrepancies.
  • Follow-up and Remediation: Implement corrective action plans based on audit outcomes to enhance overall compliance and financial performance.

Required Skills and Qualifications:

Candidates should have a strong analytical and organizational skillset, with excellent communication and leadership abilities.

Desirable skills include proficiency in billing and auditing software tools, knowledge of ISO standards, and certification in Medical Billing/Coding, RCM, or relevant certifications.

Benefits:

We offer a range of benefits, including paid leaves, HR bonus, loan policy, advance salary, yearly loyalty rewards, performance-based bonuses, leave encashment, inflation bonus, promotion, increments, and more.



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