Medical Billing Audit Specialist (Remote LatAm)

Position: Medical Billing Audit Specialist
Type: Remote- Full time

Scope of the Role

A high-volume gastroenterology practice is seeking a highly experienced U.S. healthcare billing professional to audit and optimize the performance of its third-party billing company. This is a specialist role, not administrative, requiring deep domain knowledge in medical billing and a proactive, analytical mindset.

The practice processes approximately 1,000 claims/month using Athena EMR and Karyo billing software. The ideal candidate will be a billing audit specialist who can assess AR data, identify hidden issues, and recommend revenue-boosting optimizations. You’ll serve as a key liaison between the internal team and the external billing company.

Key Responsibilities

• Audit third-party billing performance by analyzing AR reports and claim data
• Identify revenue leakage, silent denials, undercoding, or aging trends impacting cash flow
• Provide clear, actionable insights and monthly audit summaries to leadership and staff
• Track key billing KPIs and flag inconsistencies or bottlenecks
• Improve transparency and accountability of third-party billing operations
• Collaborate with internal staff and billing company representatives
• Recommend workflow improvements, policy updates, and system enhancements to boost billing performance
• Leverage Excel to build/interpret reports; spot trends and anomalies with precision

• Use Karyo billing system effectively to extract, evaluate, and verify billing activity

Requirements

• 3–5+ years of hands-on experience in U.S. healthcare billing and revenue cycle management
• Proven track record in billing audits, AR review, and revenue optimization
• Expertise with Karyo billing software and Athena EMR
• Advanced Excel skills (pivot tables, VLOOKUP, conditional formatting, trend analysis)
• Exceptional attention to detail with a proactive, problem-solving mindset
• Strong communication skills; capable of presenting billing issues and insights clearly to both clinical and non-clinical audiences
• Comfortable interfacing with external billing vendors and internal stakeholders
• Ability to work independently and efficiently in a remote setting

Ideal Candidate Profile

• Proactive auditor who spots problems before they escalate
• Deep knowledge of coding, denials management, and payer behavior
• High integrity and commitment to data transparency and financial accountability

• Familiarity with specialty billing, particularly in gastroenterology, is a strong plus