Role OverviewThe Billing QA Specialist is responsible for ensuring clean, accurate claims are released prior to submission to minimize denials and rework. This role serves as a quality checkpoint in the revenue cycle, working within Meditech work queues to resolve claim edits, validate coding and billing compliance, and support overall revenue integrity.
What You Will Do
Resolve claim edits, validate coding and billing compliance, and support overall revenue integrity. Perform detailed review of high-dollar and high-risk claims, and analyze common claim edit failures and denial trends.
Why It Might Be a Fit
The ideal candidate will have strong attention to detail, analytical/problem-solving skills, and effective communication across departments. Experience working in an HER system (MEDITECH preferred) and claim scrubber (SSI preferred) is required.
Requirements
- High school diploma or equivalent
- Associate's degree in Business-related field
- 3+ years of healthcare billing, revenue cycle, or claims experience
- Certification in CPC, CPB, or CRCR within one year of employment
- Experience working in an HER system (MEDITECH preferred)
- Experience working in a claim scrubber (SSI preferred)
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