Audit Specialist

Aeroflow Health is recruiting for an Audit Specialist who will report to the Director of Audits. The Audit Specialist supports Aeroflow’s compliance and revenue integrity by managing external payor audits and conducting internal audits to identify risk, ensure regulatory compliance, and improve operational accuracy. This role plays a key part in audit readiness, denial prevention, and continuous process improvement across revenue cycle operations.

Responsibilities

• External Payor Audit Support: Serve as a primary contact for external payor audits, including Medicare, Medicaid, and commercial insurance reviews; coordinate and prepare complete, timely audit responses, including medical records and claim documentation; review claims for medical necessity, coding accuracy, and payer compliance; interpret and apply CMS regulations, LCDs/NCDs, and commercial payor policies; track audit timelines, outcomes, and financial impact; support appeals, rebuttals, and redeterminations related to adverse audit findings.
• Internal Audit & Compliance Support: Conduct pre- and post-bill internal audits to identify compliance risks and billing errors; analyze audit findings to identify trends, root causes, and process gaps; provide clear, actionable feedback to coding, billing, and AR teams; support corrective action plans and ongoing audit readiness initiatives; assist with internal monitoring programs and quality assurance review; maintain HIPAA/patient confidentiality and ensure individual responsibility for compliance with laws, regulations, and policies.

Required Qualifications

• High school diploma or equivalent (associate or bachelor’s degree preferred).
• 3+ years of experience in auditing, compliance, coding, or revenue cycle operations.
• Strong knowledge of Medicare and Medicaid regulations and payer audit processes.
• Experience responding to external payor audits (e.g., RAC, UPIC, CERT, SMRC, or commercial audits).
• Ability to review medical documentation and claims data for compliance and accuracy.

What We Look For

• High level of integrity and trust.
• Ability to remain calm and perform duties accurately in crisis or emergency situations.
• Knowledge of principles for providing excellent customer service and satisfaction.
• Ability to interpret federal and state rules and regulations and make recommendations to management.
• Strong communication skills, including clear oral presentations to senior management and concise written reports.
• Demonstrated organization, facilitation, communication, and presentation skills.

Benefits

• Competitive pay.
• Health plans with FSA or HSA options, dental and vision insurance.
• Optional life insurance.
• 401(k) with company match.
• 12 weeks of parental leave for birthing parent; 4 weeks for non‑birthing parent(s), plus additional parental benefits such as fertility stipends, free diapers, breast pump.
• Paid holidays and PTO accrual from day one.
• Employee assistance programs.
• Recognition as Family Forward Certified, Great Place to Work Certified, Inc. 5000, Best Place to Work award winner, HME Excellence Award, Sky High Growth Award.