Claims Audit Specialist - NYCSOCW

Job Title: Claims Audit Specialist

Duties:

• Review and audit patient accounts to ensure accuracy in claims submission.
• Resolve edits, rejections, and denials through coordination with payers and internal teams.
• Maintain and update patient account systems with payment and adjustment data.
• Conduct pre-authorizations and follow up on pending claims.
• Track overdue accounts using aging reports and initiate necessary follow-ups.
• Assist patients with billing inquiries, including payment arrangement setups.

Skills Required:

• Experience in revenue cycle processes and claim resolution.
• Proficient in using accounting and claims systems.
• Fluency in English, Spanish, and French preferred.

Education:

• Bachelor’s Degree or High School diploma with equivalent work experience (4 years).