Audit and Appeal Specialist

Description

Contribute to the success of a world-class healthcare organization by ensuring compliance in regulatory audits and appeals. Leverage your expertise to support UCLA Health's commitment to accuracy and quality in claim processing.

As an Audit and Appeals Specialist, you will :

• Facilitate responses to regulatory audits related to billing, coding, and collection practices in compliance with federal and state guidelines
• Collect, analyze, and enter audit requests into relevant systems, distributing requests to necessary teams
• Monitor audit response and appeal statuses, tracking cases and maintaining updated records in various systems
• Review claim denials for clinical issues, prepare appeals, and manage each case's resolution process
• Develop internal compliance controls, addressing billing standards, regulatory updates, and potential operational gaps
• Support reporting on audit trends, outcomes, and compliance initiatives

Join UCLA Health to uphold high standards in healthcare auditing and compliance, contributing to operational excellence.

Salary Range : $31.51 - $62.64 per hour.

Qualifications

We're seeking a knowledgeable, detail-oriented professional with :