<p>Our company is searching for a<strong> Remote DRG Coding Auditor </strong>to join our client's team, performing in-depth documentation and coding audits for our healthcare clients. In this audit-focused role, you’ll conduct independent reviews of inpatient medical records, evaluating the accuracy of diagnosis and procedure codes to ensure optimal reimbursement and compliance with official guidelines, regulatory requirements, and ethical standards. Leveraging your deep knowledge of DRG payment systems (such as MS, APR, and Tricare), you’ll assess coding accuracy, documentation integrity, and identify opportunities for coder education and documentation improvement. This is a fully remote position and you can live anywhere within the US.</p><p><br></p><p><strong>Hours: </strong>Monday - Friday 8am - 5pm EST with some flexibility within the daily hours by about 2-3 hours</p><p><br></p><p><strong>Responsibilities for the position include the following:</strong></p><ul><li>Perform comprehensive audits of all acute inpatient medical records to identify coding errors, compliance concerns, and educational opportunities.</li><li>Interpret, evaluate, and apply ICD-10-CM/PCS coding principles and guidelines to ensure documentation adequately supports the coded diagnoses and procedures.</li><li>Verify that assigned DRGs accurately reflect patient severity and resource utilization according to MS, APR, Tricare, and related payment methodologies.</li><li>Research regulatory requirements and provide clear, well-supported recommendations in audit reports.</li><li>Collaborate with Clinical Documentation Integrity (CDI) specialists to pinpoint and communicate documentation and/or physician query opportunities.</li><li>Write concise, constructive feedback and educational notes for coders, referencing the latest official coding guidelines and AHA Coding Clinics.</li><li>Maintain established productivity and quality standards as measured by audit leadership.</li></ul><p><br></p>
<p>The Inpatient/DRG Validation Coding Auditor is responsible for reviewing acute inpatient medical records to ensure accurate coding, compliant documentation, and appropriate DRG assignment. The role focuses on identifying coding errors, ensuring regulatory compliance, optimizing reimbursement, and providing education and feedback to coders and CDI teams.</p><p><br></p><p>Key Responsibilities</p><ul><li>Perform detailed audits of inpatient records to validate <strong>ICD-10-CM/PCS coding</strong>, DRG assignment (MS-DRG, APR-DRG, TRICARE), and clinical documentation accuracy.</li><li>Ensure documentation supports coded diagnoses, procedures, severity of illness, and resource utilization.</li><li>Identify overpayments and underpayments through claim analysis (including 30-day lookbacks).</li><li>Provide clear, compliant audit recommendations aligned with Official Coding Guidelines and AHA Coding Clinics.</li><li>Partner with CDI specialists to identify documentation improvement and query opportunities.</li><li>Maintain productivity, quality standards, and client turnaround expectations.</li><li>Stay current on regulatory changes, reimbursement policies, and coding updates.</li><li>Contribute to process improvement initiatives and compliance risk identification.</li></ul><p><br></p>
<p>We are looking for a detail-oriented Medical Coder to support billing operations for a Long-term Contract position based in Cedar Rapids, Iowa. This role is responsible for accurately translating patient medical records into standardized codes used for billing, reporting, and compliance. The ideal candidate has a strong understanding of medical terminology, coding systems, and regulatory guidelines, with a commitment to accuracy and efficiency.</p><p><br></p><p><strong>Key Responsibilities</strong></p><ul><li>Review medical records, physician notes, and documentation to assign accurate codes for diagnoses and procedures</li><li>Apply ICD-10-CM, CPT, and HCPCS coding standards in accordance with payer and regulatory requirements</li><li>Ensure coding accuracy to support timely billing and reimbursement</li><li>Identify and resolve coding discrepancies or incomplete documentation</li><li>Collaborate with providers, billing teams, and compliance staff to clarify documentation</li><li>Maintain up-to-date knowledge of coding guidelines, payer policies, and healthcare regulations</li><li>Assist with audits and ensure adherence to HIPAA and compliance standards</li></ul><p><br></p>
<p>We are seeking a detail-oriented <strong>Clinical Medical Coder</strong> to join our healthcare team. This role is responsible for reviewing clinical documentation and accurately assigning appropriate medical codes for diagnoses, procedures, and services to support compliant billing and reimbursement processes. The ideal candidate will have strong knowledge of coding guidelines, excellent analytical skills, and a commitment to accuracy. This role is primarily remote, but candidates must live close enough to attend minimal onsite training and occasional in-person meetings as needed. </p><p><br></p><p><strong>Hours: </strong>Monday - Friday 8am -5pm</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Review patient medical records and clinical documentation to assign accurate diagnosis and procedure codes</li><li>Ensure coding compliance with payer, regulatory, and organizational guidelines</li><li>Identify and resolve coding edits, discrepancies, and documentation issues</li><li>Work closely with providers and internal departments to clarify documentation when needed</li><li>Maintain coding accuracy and productivity standards</li><li>Stay current on coding updates, regulations, and industry best practices</li></ul><p><br></p>
<p>We are seeking a detail-oriented <strong>Surgery Medical Coder</strong> to join our team. This role is primarily remote, but candidates must live close enough to attend minimal onsite training and occasional in-person meetings as needed. The ideal candidate will have coding experience in a surgical specialty environment and hold an active coding certification.</p><p><br></p><p><strong>Hours</strong>: Monday - Friday 8am -5pm</p><p><br></p><p><strong>Responsibilities for the position include the following</strong>:</p><ul><li>Review and accurately code surgical procedures, diagnoses, and related services</li><li>Ensure coding compliance with payer, regulatory, and organizational guidelines</li><li>Analyze medical documentation to assign appropriate CPT, ICD-10, and HCPCS codes</li><li>Work closely with providers and staff to clarify documentation as needed</li><li>Maintain productivity and accuracy standards in a remote work environment</li><li>Support billing and reimbursement processes through precise code assignment</li><li>Participate in minimal onsite training sessions and periodic team meetings</li></ul><p><br></p>
We are looking for a detail-oriented Claims Auditor to join a Financial Services organization in Omaha, Nebraska. In this role, you will evaluate benefit and insurance claim submissions, apply policy provisions accurately, and help ensure timely, well-documented payment decisions. This position is ideal for someone who combines analytical judgment, strong written communication, and a commitment to handling sensitive information with care.<br><br>Responsibilities:<br>• Examine claim forms, supporting records, and benefit requests to determine coverage eligibility and decide whether claims should be approved, declined, or held pending additional documentation.<br>• Record claim activity, decisions, and supporting details in the claims administration system with a high degree of accuracy and completeness.<br>• Prepare written communication to claimants, beneficiaries, financial institutions, medical providers, attorneys, and internal partners to explain outcomes or request missing information.<br>• Assess medical documentation, application details, and policy exclusions to confirm whether coverage requirements were satisfied at issue and escalate questionable disclosures for legal review when appropriate.<br>• Validate beneficiary information on life claims to confirm that proceeds are directed to the correct eligible party.<br>• Review applicable state regulations during life claim processing, including required beneficiary verification checks related to child support compliance.<br>• Recognize indicators of suspicious activity, document concerns thoroughly, and refer potential fraud matters to the appropriate legal team.<br>• Respond to questions from sales partners, account contacts, and internal teams regarding claim status, benefit determinations, and related service issues.<br>• Monitor open items and follow through on pending claims to obtain outstanding records and keep cases moving toward resolution.<br>• Support departmental workflow by assisting with cross-coverage, special assignments, and collaboration across teams to resolve issues efficiently.
<p>We are looking for an Inpatient Coding Specialist to join our team in Sacramento, California. This contract position involves reviewing and analyzing medical records to accurately assign diagnostic and procedural codes based on established guidelines and regulations. The role requires a thorough understanding of inpatient coding principles to ensure compliance with federal and state requirements while supporting efficient revenue cycle processes.</p><p><br></p><p>Responsibilities:</p><p>• Accurately assign ICD-10-CM and ICD-10-PCS codes to inpatient records based on medical documentation.</p><p>• Ensure proper grouping into Medicare Severity Diagnosis Related Groups (DRG) or All Patient Refined Diagnosis Related Groups (APR-DRG) for optimal reimbursement.</p><p>• Abstract required data elements from medical records in alignment with facility-specific guidelines.</p><p>• Monitor discharged but not billed accounts to facilitate timely and compliant revenue cycle processing.</p><p>• Collaborate with clinical documentation specialists and medical staff to validate and enhance documentation.</p><p>• Maintain high standards of coding accuracy and productivity while adhering to quality benchmarks.</p><p>• Utilize software tools such as Epic, 3M Encoder, and other coding systems to validate and compile medical information.</p><p>• Analyze and ensure compliance with coding, billing, and data collection regulations.</p><p>• Address missing or unclear information by seeking clarification and ensuring proper documentation.</p><p>• Independently manage workload and prioritize tasks to meet departmental productivity standards.</p>
We are looking for a detail-oriented Medical Claims Analyst to join a team supporting Medicaid audit and claims review activities in Raleigh, North Carolina. This contract opportunity is ideal for someone who can evaluate provider billing practices, examine payment accuracy, and contribute to compliance-focused reviews with growing independence. The role offers the chance to apply analytical judgment, strengthen audit documentation, and help improve the integrity of Medicaid-related claims operations.<br><br>Responsibilities:<br>• Review provider billing records and medical claim activity to identify discrepancies, validate payments, and assess adherence to Medicaid guidelines<br>• Carry out structured audit procedures for claims, denials, rejected claims, and billing documentation to support program integrity efforts<br>• Interpret applicable Medicaid requirements and federal regulatory standards when analyzing audit results and determining potential issues<br>• Develop clear working papers, summaries, and preliminary findings that accurately document testing performed and conclusions reached<br>• Partner with internal stakeholders to clarify claim exceptions, address audit questions, and support corrective action recommendations<br>• Analyze medical billing and Medicaid claim data to detect patterns, trends, and areas requiring additional review<br>• Contribute to compliance examinations involving provider assessments, payment verification, and operational claim review activities
We are looking for a Medical Claims Analyst to join our team in Raleigh, North Carolina on a Contract to permanent basis. This position is ideal for a detail-oriented individual who can evaluate Medicaid-related claims activity, support audit initiatives, and help maintain compliance with healthcare payment standards. The role offers the opportunity to work independently on analytical reviews while partnering with internal teams to strengthen accuracy, documentation, and regulatory alignment.<br><br>Responsibilities:<br>• Review provider records and claims activity to assess payment accuracy and identify discrepancies requiring follow-up.<br>• Perform audit procedures tied to Medicaid claims, billing practices, denials, and rejected claims to support program integrity efforts.<br>• Interpret Medicaid rules and applicable federal guidance when evaluating findings and determining compliance outcomes.<br>• Prepare organized workpapers, summaries, and preliminary reports that clearly document testing results and supporting analysis.<br>• Investigate claim issues and collaborate with stakeholders to address exceptions, recommend corrective actions, and support resolution plans.<br>• Analyze medical billing and reimbursement data to detect trends, payment concerns, and areas of potential financial risk.<br>• Support compliance reviews involving provider activity, claim adjudication, and payment validation across assigned cases.
<p>benefits:</p><ul><li>paid time off</li><li>paid holiday</li><li>medical insurance</li><li>dental</li><li>vision</li></ul><p><strong>Responsibilities:</strong></p><ul><li>Submit medical claims to insurance companies in a timely manner</li><li>Review and verify patient information, coverage, and billing details</li><li>Follow up on unpaid or denied claims and resolve discrepancies</li><li>Post payments, adjustments, and patient payments accurately</li></ul><p><br></p>
<p>We are seeking a Medical Biller to support accurate and timely billing operations for a healthcare organization. This role is responsible for claim submission, payment posting, follow‑up, and resolving billing discrepancies to ensure clean claims and steady revenue flow.</p><p><br></p><p>Why This Role:</p><ul><li>Join a stable healthcare organization with established billing processes</li><li>Opportunity to make a direct impact on revenue and operational efficiency</li><li>Collaborative environment with room for growth based on performance</li></ul><p>Key Responsibilities:</p><ul><li>Prepare, review, and submit medical claims to insurance carriers and government payers</li><li>Verify patient demographics, insurance coverage, and authorization prior to billing</li><li>Post payments, adjustments, and denials accurately in the billing system</li><li>Follow up on unpaid or underpaid claims and resolve billing rejections</li><li>Review EOBs/ERAs and research discrepancies or payer issues</li><li>Work closely with coding, registration, and clinical teams to correct errors and reduce denials</li><li>Maintain clear, compliant billing documentation and audit‑ready records</li><li>Ensure adherence to payer requirements, HIPAA guidelines, and internal billing policies</li></ul><p><br></p>
<p>Join our client's team as a <strong>Remote Inpatient Coding Specialist</strong> and play an essential role in ensuring accurate medical coding and billing processes. As a subject matter expert, you will use your knowledge of ICD-10-CM, ICD-10-PCS, HCPCS, NCCI, CMS, and CMG coding standards to review appeals and denials. Your expertise will help substantiate coding principles, address potential billing and coding concerns, and maintain high-quality standards in documentation. This is a fully remote position.</p><p><br></p><p><strong>Hours: </strong>Monday - Friday 8am -5p EST with flexibility</p><p><br></p><p>Responsibilities:</p><ul><li>Apply medical coding principles and industry guidelines objectively during appeals and denial review processes.</li><li>Leverage knowledge of ICD-10-CM, ICD-10-PCS, HCPCS, NCCI, CMS, and CMG to identify, analyze, and resolve billing and coding issues.</li><li>Assess quality concerns by verifying adherence to regulatory requirements and best practices.</li><li>Participate in client system education to gain familiarity with specific platforms and workflows.</li><li>Ensure all appeals are accurately supported by clinical documentation, coding/CDI guidelines, and regulatory standards.</li><li>Collaborate with clients and internal stakeholders to clarify documentation and coding requirements.</li></ul><p><br></p>
<p>We are seeking a detail-oriented <strong>Medical Billing Specialist</strong> to join our healthcare team. This role is responsible for accurate billing, claims submission, payment posting, and follow-up to ensure timely reimbursement from insurance carriers and patients. The ideal candidate has a strong understanding of medical billing processes, payer rules, and HIPAA compliance.</p><p>Key Responsibilities</p><ul><li>Prepare, review, and submit medical claims to commercial insurance, Medicare, and Medicaid</li><li>Verify patient insurance eligibility and benefits</li><li>Post payments, adjustments, and denials accurately</li><li>Follow up on unpaid or denied claims and resolve billing discrepancies</li><li>Review Explanation of Benefits (EOBs) for accuracy</li><li>Communicate with insurance companies, patients, and internal teams regarding billing questions</li><li>Maintain patient confidentiality and comply with HIPAA regulations</li><li>Ensure billing practices align with payer guidelines and company policies</li></ul><p><br></p>
We are looking for a detail-oriented Medical Billing Specialist to support healthcare billing operations in Middletown, Rhode Island. This Long-term Contract position is ideal for someone who can manage claims activity accurately, follow billing procedures closely, and help maintain timely reimbursement through consistent account follow-up.<br><br>Responsibilities:<br>• Process medical claims with accuracy and ensure billing information is complete before submission.<br>• Review coding and billing details to identify discrepancies and resolve issues that could delay payment.<br>• Follow up on unpaid or underpaid accounts with payers to support timely collections.<br>• Maintain billing records and update account documentation to reflect claim status and payment activity.<br>• Use EPACES and related systems to verify claim information and assist with billing workflows.<br>• Communicate with internal stakeholders and external payers to address denials, rejections, and payment questions.
<p>We are seeking a detail-oriented Medical Billing Specialist to join our team. This role is responsible for processing insurance claims, verifying patient information, following up on unpaid claims, and ensuring accurate billing and reimbursement.</p><p>Responsibilities</p><ul><li>Submit and manage medical claims</li><li>Verify insurance eligibility and benefits</li><li>Resolve claim denials and billing discrepancies</li><li>Post payments and maintain accurate records</li><li>Communicate with patients and insurance providers</li></ul><p><br></p>
<p>We are looking for a detail-oriented Medical Billing Specialist to join our healthcare team in French Camp, California. This Contract to permanent position requires expertise in managing complex billing processes, interpreting healthcare policies, and providing exceptional customer service to patients and clients. The ideal candidate will bring advanced knowledge of billing systems, claim administration, and financial operations to ensure accuracy and efficiency in all tasks.</p><p><br></p><p>Responsibilities:</p><p>• Handle specialized and intricate billing processes, including accounts receivable and appeals management.</p><p>• Research and apply healthcare policies, regulations, and procedures to support accurate claim administration.</p><p>• Compile, maintain, and process financial data for billing, reimbursement, and reporting purposes.</p><p>• Utilize advanced systems and software such as Allscripts, Cerner Technologies, and EHR systems to manage patient information and billing records.</p><p>• Conduct in-depth reviews of legal, custody, and medical records to ensure compliance with reimbursement requirements.</p><p>• Provide clear and effective communication with patients, clients, and external agencies to address inquiries and resolve billing issues.</p><p>• Develop and maintain spreadsheets or databases to track financial operations and generate detailed reports.</p><p>• Prepare and review complex documents, including insurance claims, treatment authorization forms, and subpoenas.</p><p>• Train or oversee clerical staff as needed, ensuring adherence to office practices and procedures.</p><p>• Assist in coordinating administrative functions, such as payroll, purchasing, and inventory management.</p><p>For immediate consideration please contact Cortney at 209-225-2014</p>
We are looking for a Medical Billing Specialist to support a Contract opportunity in Aloha, Oregon. This role focuses on accurate billing operations, insurance-related coordination, and claim resolution within a mission-driven behavioral health setting. The ideal candidate brings prior medical billing experience, knowledge of Medicare or Medicaid processes, and a thoughtful, service-oriented communication style suited to a non-profit environment.<br><br>Responsibilities:<br>• Manage billing activities by preparing, reviewing, and submitting medical claims with a strong focus on accuracy and timeliness.<br>• Confirm insurance coverage and determine benefit eligibility before services are billed to help reduce denials and payment delays.<br>• Investigate unpaid or denied claims, communicate with payers as needed, and take corrective action to secure reimbursement.<br>• Coordinate authorization-related billing support for varying levels of care, including CareOregon-related processes when applicable.<br>• Maintain complete and organized billing records in designated systems such as Credible and Qualifacts.<br>• Assist with medical collections follow-up and other billing support duties based on team priorities and workload demands.<br>• Work collaboratively with internal staff to address claim issues while delivering attentive and empathetic communication.<br>• Monitor account status and identify discrepancies so billing concerns can be resolved efficiently.<br>• Contribute to daily revenue cycle activities in alignment with compliance standards and organizational procedures.
<p>We are seeking a detail-oriented Medical Biller with strong customer service skills to support billing operations and provide a positive experience for patients and internal partners. This role requires accuracy, professionalism, and the ability to communicate clearly while resolving billing questions and issues. This is a<strong> part-time</strong> role only. </p><p> </p><p><strong>Responsibilities</strong></p><ul><li>Process and submit medical claims accurately and timely to insurance carriers</li><li>Review patient accounts and insurance payments to ensure correct posting and follow-up</li><li>Respond to patient billing inquiries with professionalism, empathy, and clear explanations</li><li>Resolve billing issues, payment discrepancies, and rejected or denied claims</li><li>Coordinate with insurance companies, providers, and internal teams to resolve account issues</li><li>Maintain accurate documentation and notes within billing systems</li><li>Follow HIPAA guidelines and maintain confidentiality of patient information</li></ul><p><br></p>
We are looking for a Medical Billing Specialist to join a healthcare team in Merrillville, Indiana. This contract-to-permanent opportunity is ideal for someone who can manage billing activities accurately, follow claims through the reimbursement cycle, and support steady cash flow in a fast-paced environment. The role requires strong attention to detail, working knowledge of medical billing and coding practices, and the ability to resolve account issues efficiently.<br><br>Responsibilities:<br>• Prepare and submit medical claims accurately and on schedule to support timely reimbursement.<br>• Review billing documentation and coding details to identify errors, missing information, or claim discrepancies before submission.<br>• Monitor unpaid or denied claims, investigate the cause, and take corrective action to improve collection outcomes.<br>• Communicate with payers, patients, and internal staff to resolve billing questions and outstanding account balances.<br>• Maintain detailed records of claim activity, payment updates, and follow-up efforts within the billing system.<br>• Apply medical billing and coding knowledge to ensure charges align with supporting documentation and payer requirements.<br>• Assist with accounts receivable follow-up to reduce aging balances and keep reimbursement activity moving forward.<br>• Support billing operations using Athena software and contribute to process updates within the department as needed.
<p>We are seeking a <strong>Medical Billing Specialist</strong> to join our team immediately. This is a great opportunity for someone who thrives in a <strong>fast-paced, team-oriented healthcare environment</strong> and can manage multiple priorities while maintaining strong accuracy and follow-through. **This position requires in office presence in Chattanooga, Tennessee**</p><p><br></p><p>Position Overview</p><p>The Medical Billing Specialist will support billing operations across a variety of healthcare service lines. This role requires a strong understanding of medical billing processes, payment posting, denial management, and insurance follow-up, with particular familiarity in <strong>Medicare and Medicaid billing and claims</strong>. We are looking for someone adaptable, self-directed, and ready to grow with the team.</p><p><br></p><p>Key Responsibilities</p><ul><li>Process medical billing in a high-volume, fast-paced setting</li><li>Review and resolve billing edits, claim issues, and denials</li><li>Perform insurance follow-up and work outstanding claims to resolution</li><li>Post payments accurately and timely</li><li>Support reconciliation and tracking of payments using Excel spreadsheets</li><li>Ensure compliance with billing rules, regulations, payer requirements, and reimbursement guidelines</li><li>Work with commercial insurance, Medicare, and Medicaid claims</li><li>Communicate professionally with internal teams and, when needed, directly with patients regarding billing questions or account issues</li><li>Assist with additional revenue cycle and billing support functions as needed</li><li>Maintain detailed, accurate documentation and strong account follow-up</li></ul>
We are looking for a detail-oriented Medical Billing Specialist to support a nonprofit healthcare-focused organization in Auburn Hills, Michigan. This Contract position is ideal for someone who brings strong experience with Medicaid-related billing activity, including eligibility review and financial determination processes. The successful candidate will be comfortable working independently, resolving billing issues efficiently, and adapting quickly in a fast-paced environment.<br><br>Responsibilities:<br>• Review Medicaid eligibility cases and complete financial assessments, including spend-down evaluations, with accuracy and timeliness.<br>• Prepare, submit, and monitor medical claims to help ensure proper reimbursement and reduce payment delays.<br>• Investigate outstanding accounts and perform follow-up activities to address denials, underpayments, and unpaid balances.<br>• Apply medical billing and coding knowledge to maintain compliant claim documentation and support clean claim submission.<br>• Communicate with payers, internal staff, and relevant stakeholders to clarify claim issues and secure needed information.<br>• Maintain organized records of billing activity, eligibility decisions, claim status updates, and collection efforts.<br>• Identify discrepancies in account information and take corrective action to improve billing accuracy and account resolution.
<p>Robert Half is seeking an Internal Auditor with Banking experience. </p><p>Does this sound like you?</p><ul><li> Experience with Financial Crimes Compliance Technology audit</li><li>SQL Querying is preferred</li><li>Issue Validation</li><li>Walkthroughs, testing, workpapers </li></ul><p><br></p>
We are looking for an experienced IT Auditor to support a contract engagement based in Cincinnati, Ohio. This role is well suited for someone who is detail oriented, can work independently, contribute approximately 20 hours per week, and provide practical guidance across IT audit and controls activities. The position will partner with stakeholders to strengthen documentation, assess control effectiveness, and help address areas requiring improvement in a newly public company environment.<br><br>Responsibilities:<br>• Lead and contribute to IT control walkthroughs, offering informed feedback and practical recommendations during the review process.<br>• Evaluate audit evidence and testing results to determine whether technology controls are appropriately designed and operating as intended.<br>• Develop, refine, and review client-facing documentation such as process narratives, risk and control matrices, control guides, policies, and related standards.<br>• Help identify control deficiencies and translate findings into clear, actionable remediation plans.<br>• Support execution of corrective actions tied to control gaps and monitor progress against agreed objectives.<br>• Provide regular updates on audit support efforts, open items, and overall status of assigned workstreams.<br>• Apply IT audit knowledge to assess controls in alignment with broader governance and compliance expectations.<br>• Work independently while coordinating effectively with client leadership and other stakeholders involved in audit activities.
We are looking for an experienced IT Auditor to join our team in Cincinnati, Ohio. In this role, you will conduct risk-based audits and integrated reviews of systems, applications, and cybersecurity controls to ensure compliance and identify areas for improvement. You will also collaborate with external and regulatory auditors while maintaining strong relationships with internal business units.<br><br>Responsibilities:<br>• Conduct risk-based audit procedures across various scheduled projects, ensuring adherence to approved audit programs and high standards.<br>• Analyze and document the internal controls of both manual and automated systems, identifying strengths and areas for improvement.<br>• Prepare detailed audit work papers that thoroughly document tests performed and comply with departmental guidelines.<br>• Draft comprehensive reports, including summary memoranda and recommendations, that outline findings and provide actionable solutions.<br>• Lead small to medium-sized audit projects, supervising staff auditors and interns as needed.<br>• Evaluate cybersecurity controls and management systems to ensure protection against risks and vulnerabilities.<br>• Assist external and regulatory auditors by providing necessary documentation and insights.<br>• Maintain effective communication and collaboration with business unit management to address audit findings and recommendations.<br>• Stay up-to-date on industry standards and emerging technologies to enhance audit processes.
We are looking for a Medical Accounts Receivable Specialist to join a pharmaceutical organization in Dallas, Texas on a contract-to-permanent basis. This position supports the financial operations team by managing insurance-related receivables, applying payments accurately, and addressing outstanding balances in a timely manner. The role also contributes to stronger accounts receivable performance by improving daily workflows, supporting team effectiveness, and helping maintain accurate financial records.<br><br>Responsibilities:<br>• Manage carrier collections by researching unpaid or underpaid claims and pursuing resolution with third-party payers.<br>• Record and reconcile insurance remittance activity, including electronic files, manual payments, and live check deposits, to ensure accounts are updated correctly.<br>• Review exception and error reporting each day, resolve posting issues, and route required documentation to appropriate internal teams.<br>• Retrieve missing remittance details from payer portals and complete accurate payment posting when electronic files are unavailable.<br>• Maintain daily deposit tracking and reconciliation records for insurer payments, Medicaid receipts, checks, and other incoming funds.<br>• Prepare and distribute invoices for aging balances within designated billing cycles, including 30- to 60-day accounts.<br>• Transfer chargeback information to tracking tools so follow-up collection activity can be completed by the appropriate staff.<br>• Respond to receipt-related requests through the service desk system and provide timely support for internal stakeholders.<br>• Assist in strengthening accounts receivable operations by identifying process improvements and supporting efficient use of available technology.