Medicare Recovery Audit Specialist
$20.38/h-$36.44/h
Optum2 days ago
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HybridFull-timeEntry
Summary
Optum is seeking a Medicare Recovery Audit Specialist to join their team in Concord, CA. The role involves identifying and addressing improper Medicare payments through retrospective claims review.
About the Role
As a Medicare Recovery Audit Specialist, you will be responsible for conducting audits and reviews of Medicare claims, analyzing medical records and billing documentation, and ensuring compliance with CMS regulations. You will prepare detailed audit findings, participate in appeal preparations, and communicate findings to internal stakeholders. The position requires flexibility to work full-time Monday to Friday, with one in-office day per week.
About You
Required:
- High School Diploma / GED
- Working knowledge of Medicare remittance advice, recoupments, and appeals processes
- Experience with CMS/Medicare billing, including UB-04 form requirements
- Experience with Electronic Health Records (EHR) & Practice Management Systems (PMS)
- Proficient with Microsoft Office (Excel, Word, Outlook, PowerPoint)
- Ability to work onsite one day per week at 5003 Commercial Circle, Concord, CA 94520
Preferred:
- Experience with Epic EHR
Benefits
- Comprehensive benefits package including medical, dental, and vision coverage.
- Incentive and recognition programs.
- Equity stock purchase and 401k contribution.
Optum
We’re evolving health care so everyone can have the opportunity to live their healthiest life. It’s why we put your unique needs at the heart of everything we do, making it easy and affordable to manage health and well-being. We are delivering the right care how and when it’s needed; providing support to make smarter and healthier choices; and making prescription services easier, while helping you save money along the way. It’s everything health care should be. Together, for better health. Optum is part of UnitedHealth Group (NYSE: UNH).
Concord, CA