ACU-Serve · 5 months ago
Quality Assurance Audit Analys
United States
Full-time
Remote
Mid LevelACU-Serve is a company that delivers billing solutions to DME, HME, and Home Infusion providers, helping them to grow their business while improving collection processes. The Claims Analyst is responsible for performing quality reviews for audits and ensuring compliance with established guidelines, while also addressing inquiries and developing resources for both employees and clients.
CRMInformation Technology
Responsibilities
Perform quality reviews for both Pre-Pay and Post-Pay audits as well as the client’s orders prior to and/or confirmation, according to established guidelines, that assist management in monitoring the quality, consistency and effectiveness of business processes, procedures and related tools
Follow defined audit processes in conducting quality reviews
Keep current on new coding and billing guidelines, federal and state initiatives
Ensure the consistent use of current codes, correct information, documentation and departmental procedures by monitoring their use and identifying any deficiencies
Prepare summaries for management of quality review results, including basic analysis of identified deficiencies
Reduce quality related errors by making recommendations to increase the efficiency of operations
Assist with policy, procedure development and implementation as it relates to the claim review processes
Review coding variances including supporting documentation, review of old and new procedure codes, consult and collaborate Director of Compliance as necessary
Prepare supporting documentation as necessary
Based on audits and claims reviews, prepare supporting documentation requests for configuration changes to ensure that configuration mirrors provider contract
Keep current on new coding and billing guidelines, federal and state initiatives. Educate other departments on new/changes to regulations as necessary
Coordinate recoupment efforts with Director of Compliance due to billing errors and over payments
Respond to provider inquiries regarding recoupments in writing and/or verbally when necessary
Perform departmental quality audits
Produce and deliver monthly a summary report of changes to the Director of Compliance; include relevant source documents
Qualification
Required
Durable Medical Equipment experience is required
Must have knowledge of payor requirements for billing, auditing, and/or contracting with a strong background of Medicare LCD requirements
Excellent written and verbal communication skills
Must have knowledge of word, excel, and power point
Demonstrated ability to develop strong business partnerships and relationships with payors
Work closely with other internal customers
Company
ACU-Serve
At ACU-Serve, we go beyond traditional revenue cycle management to help healthcare providers optimize operations, improve cash flow, and enhance patient care.
Founded in 1993
501-1000 employees
H1B Sponsorship
ACU-Serve has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (1)
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Lovell Minnick Partners
2023-10-19Private Equity
Recent News
2025-08-05
2025-06-18
2025-02-21
Company data provided by crunchbase