Neuromonitoring Associates Visa Sponsorship USA

Position Title: Post-Adjudication Auditor

Department: Accounts Receivable

Reports to: Accounts Receivable Team Lead

FLSA: Non-Exempt

Position Summary

The Post-Adjudication Auditor is responsible for evaluating claim outcomes after actions such as calls, appeals, or adjustments have been completed. This role ensures appropriate next steps are applied, whether that means closing the claim, escalating, further disputing, or routing it to another department. Acting as a quality control checkpoint, the Post-Adjudication Auditor reduces rework, strengthens resolution accuracy, and supports overall billing efficiency. The position also requires professional communication and strict adherence to departmental policies, procedures, and best practices.

Essential Duties & Responsibilities

• Review patient accounts and claims after actions have been taken (e.g., phone calls, appeals, adjustments).
• Determine whether claims should be closed, escalated, further disputed, or routed to another department.
• Take necessary actions to further dispute claims when appropriate.
• Provide quality control to ensure claim handling is accurate and complete, reducing errors and rework.
• Identify and report payer denial, payment, recoupment trends, and out-of-network errors to leadership.
• Prepare and maintain accurate documentation, files, and follow-up notes in accordance with departmental procedures.
• Respond to additional documentation requests (ADR), audits, and post-payment reviews as assigned.
• Scan all relevant claim and patient documents into the electronic health record (EHR).
• Track and analyze outcomes to identify patterns or areas for process improvement.
• Meet all established daily, weekly, and monthly performance metrics.
• Perform additional duties as assigned.

Qualifications & Requirements

Education Licenses/Certifications

• High School Diploma or equivalent. Bachelor’s degree preferred.

Experience

• Minimum of 2 years accounts receivable experience in the medical field required.
• Proficiency with medical terminology, insurance industry practices, and out-of-network billing.
• Proficiency with CPT, ICD-10 and HCPCS coding required.

Skills & Competencies

• Ability to prioritize and handle multiple tasks in a changing work environment.
• Strong analytical skills with the ability to evaluate outcomes and recommend next steps.
• Excellent attention to detail and accuracy in documentation.
• Strong written and verbal communication skills.
• Ability to work independently and as part of a team.
• Proficiency in interpreting Explanations of Benefits (EOBs) and applying appropriate follow-up actions.
• Proficiency with Microsoft Office applications and database software.

Working Conditions

Generally, work in an office environment.

• Frequent and prolonged periods of computer and office equipment usage.
• Standard business hours with occasional overtime to meet project deadlines.
• Ability to manage stress and maintain productivity under tight deadlines and changing priorities.
• Regular interaction with team members, clients, and other stakeholders through various communication channels.

Physical Demands

• Ability to maintain stationary position for extended periods.
• Occasionally required to move short to moderate distances.
• Must be able to lift and/or move up to 50 pounds occasionally.

Disclaimer: The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Employees must be able to perform the essential functions of the position satisfactorily. Furthermore, the statements do not establish a contract for employment and are subject to change at the discretion of the Company with or without advance notice.