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Government Audit Recovery Specialist

Integrated Resources, Inc

Costa Mesa, CA

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JOB DETAILS
SALARY
$25–$28 Per Hour
SKILLS
Acute Care, Apple Macs, Auditing, Billing, Billing Records, Centers for Medicare and Medicaid Services (CMS), Content Management Systems (CMS), Data Entry, Government, Government Contracts, Government Regulations, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Mail Processing, Medi-Cal, Medicaid, Medical Billing, Medical Coding, Medicare, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft PowerPoint, Microsoft Word, Organizational Development/Management, Privacy Controls, Privacy Regulations, Quality Management, Regulations, Reimbursement, Testing, Training/Teaching, Utilization Management
LOCATION
Costa Mesa, CA
POSTED
5 days ago
Title: Government Audit Recovery Specialist
Location: Costa Mesa, CA
Contract Period: 3 months
Pay Range: $25 - $28
 
Position Summary:
  • The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and enforcement agency audits for documentation and billing compliance.
  • This includes data entry, processing of mail, preparation of audit information, and correspondence with government contractors as needed.
    This role has a fundamental understanding of the RAC program and other audits for documentation and billing compliance.
  • As an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Client Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits.
  • The Government Recovery Specialist performs duties associated with Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program and other government regulatory and enforcement agency audits for documentation and billing compliance. This includes data entry, processing of mail, preparation of audit information, and correspondence with government contractors as needed.
  • This role has a fundamental understanding of the RAC program and other audits for documentation and billing compliance. As an essential role and focal point of all government audit activity, the Government Recovery Specialist is responsible for responding to correspondence from Government Agencies related to Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Client Provider Education (TPE), Comprehensive Error Rate Testing (CERT), Office of Inspector General (OIG), Quality Improvement Organizations (QIO) and other Medicaid, Medi-Cal regulatory auditing body for pre and post payment audits.
Skills:
  • 3 years of Medicare billing, billing follow-up, and appeals experience in an acute care setting.
  • 1–3 years of experience supporting regulatory audits and appeals in an acute care environment.
  • Experience working on complex projects.
  • Understanding of CMS billing, payment, and reimbursement methodologies.
  • Knowledge of CMS rules and regulations, HIPAA/privacy regulations, security regulations, and release of information requirements.
  • Proficiency with Microsoft Office applications (Word, Excel, PowerPoint, and Outlook).
Preferred Skills & Experience:
  • 5+ years of experience in an acute care setting.
  • 3+ years of experience supporting healthcare regulatory audits and appeals.
  • Experience with government audits including RAC, MAC, TPE, CERT, OIG, Medicaid, and Medi-Cal audits.
  • 5+ years of Medicare billing, follow-up, and appeals experience.
  • Knowledge of utilization management processes, medical coding, and medical necessity criteria.
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About the Company

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Integrated Resources, Inc