Skilled Wound Care ยท 2 days ago
Medicare Audit Manager
United States
Full-time
Remote
Entry, Mid Level
$30/hr - $35/hr
2+ years expSkilledWoundCare is seeking a Medicare Audit Manager responsible for managing Medicare accounts receivable with a focus on payment takebacks and recoupments. This role involves working closely with billing, coding, clinical, and compliance teams to ensure timely responses to Medicare payment adjustments and maintain compliance with CMS and MAC requirements.
Health Care
No H1B
Responsibilities
Manage Medicare accounts receivable for wound care services, including follow-up on underpayments, denials, and unpaid balances
Monitor Medicare remittance advice (RAs) for takebacks, adjustments, and recoupment activity
Research and resolve Medicare payment discrepancies related to wound care claims
Track and reconcile Medicare payment reversals, offsets, and demand letters
Handle Medicare requests for payment takebacks, including RAC, UPIC, SMRC, and MAC-initiated recoupments
Review wound care claims and documentation to determine validity of takeback requests
Coordinate with coding, clinical, and compliance teams to gather supporting documentation
Prepare and submit timely redeterminations, reconsiderations, and appeal packets as appropriate
Track appeal deadlines, outcomes, and recoupment status to minimize cash flow disruption
Communicate with Medicare Administrative Contractors (MACs) regarding recoupment resolution
Provide feedback to providers and billing teams to prevent repeat recoupments
Maintain detailed documentation of Medicare collection and recoupment activity
Prepare reports on Medicare A/R, takebacks, appeal success rates, and trends
Ensure compliance with CMS billing, appeals, and collections regulations
Assist with process improvement initiatives to reduce Medicare payment risk
Qualification
Required
2+ years of experience in Medicare collections, billing follow-up, or revenue cycle management
Strong working knowledge of Medicare remittance advice, recoupments, and appeal processes
Experience working with Medicare Administrative Contractors (MACs)
Proficiency with EHRs, practice management systems, and Microsoft Office (Excel, Word, Outlook)
Strong analytical, organizational, and communication skills
CANDIDATE MUST BE BASED IN THE US
Preferred
Associate's or Bachelor's degree in Healthcare Administration, Health Information Management, Business, or related field (or equivalent experience)
Experience in outpatient wound care, specialty clinics, or hospital-based wound centers
Knowledge of wound care coding and coverage requirements (CPT, HCPCS, ICD-10)
CPC, CCS, or similar coding certification
Experience managing RAC, UPIC, or SMRC recoupments and appeals
Strong understanding of Medicare collections workflows
Attention to detail and deadline management
Effective written and verbal communication with payers and internal teams
Problem-solving and appeal strategy skills
High level of integrity and confidentiality
Benefits
Competitive compensation
Medical
Dental
Vision
401K
PTO
Potential performance-based bonus
Full-time remote position
Company
Skilled Wound Care
Skilled Wound Care provides professional wound, skin, and ostomy services to patients in nursing homes.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Bardia Anvar, MD
CEO
John Hensley
Vice President of Partnership Developenent
Recent News
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