Audit and Recovery Analyst- Remote

About the role

The AUDIT AND RECOVERY ANALYST role supports the audit and recovery team by executing audit initiatives aligned with established policies and guidelines. This position is critical in ensuring proper documentation and substantiation for medical services, contributing to accurate payment processes and provider communication. The role impacts the organization by maintaining compliance and supporting financial integrity in healthcare operations.

Responsibilities

• Maintain knowledge of procedural codes and required documentation for service verification and payment substantiation
• Assist in developing and implementing audit activities, including preparing medical record requests and completing audits
• Process and complete appeals of adverse payment determinations
• Collaborate with supporting departments on audit and recovery issues
• Participate in policy development
• Address provider inquiries about audit processes and rights
• Resolve problems with limited standardization
• Interact with appeals processes regarding overpayment determinations
• Communicate effectively in writing and orally
• Maintain positive relationships with providers, clinical staff, and colleagues
• Accurately document provider communications
• Coordinate with audit and recovery staff on audit-related tasks
• Present information and respond to questions from various stakeholders
• Utilize software applications necessary for the role

Requirements

• Undergraduate degree in specialized physical medicine from an accredited institution
• Current licensed or certified Physical Therapist or Chiropractor with state licensure

Pay

Salary range from $72,800 to $130,000 annually based on full-time employment

Benefits

• Incentive and recognition programs
• Equity stock purchase
• 401(k) contributions