AR Auditor

Job not on LinkedIn

6 days ago

🏄 California – Remote

Although this job is listed in California, this company may be open to hiring remote in other states.

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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Healthrise

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Healthcare Insurance • Consulting • SaaS

Healthrise is a company dedicated to providing comprehensive healthcare solutions, focusing on revenue cycle management, electronic health record (EHR) services, and strategic consulting. With over a decade of experience, Healthrise assists health systems nationwide in achieving operational and financial success through tailored strategies. Their team of experts partners with healthcare organizations to tackle complex operational challenges and enhance efficiency, ensuring both patient and financial outcomes are optimized.

51 - 200 employees

⚕️ Healthcare Insurance

☁️ SaaS

📋 Description

• Conduct audits of AR processes, including payment posting, adjustments, and follow-up activities, to ensure compliance with contracts, policies, and regulatory requirements. • Analyze, categorize, and resolve claim denials from California commercial, government, and managed care payers. • Identify root causes of denials, recommend solutions, and support corrective actions to optimize financial performance. • Plan, execute, and document audits using appropriate methodologies and tools to assess efficiency and integrity of revenue cycle processes. • Ensure appeals and reconsiderations are submitted according to California payer timelines and regulatory standards. • Adapt to evolving regulatory changes, technology updates, and organizational priorities. • Prepare audit reports, summaries, and recommendations for management. • Communicate findings and trends to stakeholders to support decision-making and process improvement.

🎯 Requirements

• Required High School Diploma or equivalent. • Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or related field preferred. • Experience with California Medicaid, Share of Cost, and managed care environments. • 2–3 years of experience with California-specific payers (Medi-Cal, Blue Shield of CA, Kaiser, CalOptima, IEHP, Partnership HealthPlan, Division of Financial Responsibility, Share of Cost). • Preferred Certified Professional Biller (CPB), Certified Reimbursement Specialist (CMRS), or equivalent.