Audit Specialist (Medical Billing)

Meds IT Nexus is looking for a detail-oriented Audit Specialist in Medical Billing to join their team full-time at their Rawalpindi office. This role requires conducting daily quality assurance audits to identify billing errors and ensure compliance for US-based healthcare accounts. The position operates on an evening/night shift from 5:30 PM to 2:30 AM, Monday through Friday. The ideal candidate will be passionate about accuracy, compliance, and quality control within the medical billing process, with a strong focus on maintaining high standards in billing accuracy and regulatory adherence.

Key Responsibilities
Conduct thorough quality assurance audits across various stages including charge entry, claim scrubbing, payment posting, and accounts receivable follow-up. Review claim files, clinical notes, and billing records to verify correct CPT, ICD-10, and HCPCS coding, ensuring proper use of modifiers. Audit payment posting accuracy by checking contracted rates, fee schedules, and patient responsibility balances to identify underpayments or posting errors. Perform root-cause analysis on claim denials, rejections, and billing discrepancies, and recommend corrective actions. Ensure compliance with HIPAA data security regulations, payer rules, OIG guidelines, and client-specific protocols. Maintain accurate audit scorecards, track error trends, and prepare daily and weekly quality reports for management. Provide ongoing feedback and workflow guidance to billing associates to reduce errors and enhance operational efficiency.

Required Qualifications
Candidates should have 2 to 3+ years of experience in US Medical Billing, with a focus on quality control, auditing, or denial analysis. A strong understanding of US Revenue Cycle Management (RCM) is essential, including knowledge of CPT/ICD-10 coding guidelines, Medicare/Medicaid policies, and commercial payer regulations. Hands-on experience with major EHR and billing platforms such as AdvancedMD, eClinicalWorks, Kareo/Tebra, Practice Fusion, OfficeAlly, EncoderPro, and payer portals is required. Proficiency in Microsoft Excel, including pivot tables, data filtering, and reporting formulas, along with strong analytical and troubleshooting skills, is necessary. Excellent written and verbal communication skills in English are important for clear report generation and effective feedback. A Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field is required.

Preferred Qualifications and Benefits
The company offers a competitive market salary with inflation bonuses, HR performance bonuses, regular salary increments, and participation in the Employee Equity Funds Program (EEFP). Employees enjoy fixed weekends off (Saturday and Sunday) to support work-life balance. Complimentary dinner and daily tea/green tea breaks are provided at the office. Additional employee support programs include paid leaves, leave encashment options, a company loan policy, and advance salary facilities.

Candidates should be prepared to discuss their experience as an Audit Specialist in Medical Billing, current and expected salary, notice period, and their ability to commute to the night shift location at Asghar Mall, Murree Road, Rawalpindi. This is an on-site role requiring reliable attendance during the specified evening/night hours.