Audit Specialist

Job Description

Job Description

Aeroflow Health –Audit Specialist

Aeroflow is recruiting for an Audit Specialist who will report to the Director of Audits. 

The Audit Specialist supports Aeroflow’s compliance and revenue integrity by managing external payor audits and conducting internal audits to identify risk, ensure regulatory compliance, and improve operational accuracy. This role plays a key part in audit readiness, denial prevention, and continuous process improvement across revenue cycle operations.

Primary Responsibilities

External Payor Audit Support

• Serve as a primary contact for exte rnal payor audits , including Medicare, Medicaid, and commercial insurance reviews
• Coordinate and prepare complete, timely audit responses, including medical records and claim documentation
• Review claims for medical necessity, coding accuracy, and payer compliance
• Interpret and apply CMS regulations, LCDs/NCDs, and commercial payor policies
• Track audit timelines, outcomes, and financial impact
• Support appeals, rebuttals, and redeterminations related to adverse audit findings

Internal Audit & Compliance Support

• Conduct pre- and post-bill internal audits to identify compliance risks and billing errors
• Analyze audit findings to identify trends, root causes, and process gaps
• Provide clear, actionable feedback to coding, billing, and AR teams
• Support corrective action plans and ongoing audit readiness initiatives
• Assist with internal monitoring programs and quality assurance review
• Employee has an individual responsibility for knowledge of and compliance with laws, regulations, and policies.
• Compliance is a condition of employment and is considered an element of job performance.
• Maintain HIPAA/patient confidentiality

Required Qualifications

• High school diploma or equivalent required; associate or bachelor’s degree preferred
• 3+ years of experience in auditing, compliance, coding, or revenue cycle operations
• Strong knowledge of Medicare and Medicaid regulations and payer audit processes
• Experience responding to external payor audits (e.g., RAC, UPIC, CERT, SMRC, or commercial audits)
• Ability to review medical documentation and claims data for compliance and accuracy

What we look for

We are looking for high motivated talented individuals who have:

• A high level of integrity and trust
• The ability to remain calm and perform duties accurately in crisis or emergency situations
• Knowledge of principles for providing excellent customer service and satisfaction
• The ability to interpret rules and regulations (federal and state-by-state), and make recommendations to management concerning the same
• The ability to communicate clearly, make oral presentations to senior management, and prepare concise detailed written reports
• Demonstrated organization, facilitation, communication, and presentation skills.

What Aeroflow Offers

Competitive Pay, Health Plans with FSA or HSA options, Dental, and Vision Insurance, Optional Life Insurance, 401K with Company Match, 12 weeks of parental leave for birthing parent/ 4 weeks leave for non-birthing parent(s), Additional Parental benefits to include fertility stipends, free diapers, breast pump, Paid Holidays, PTO Accrual from day one, Employee Assistance Programs and SO MUCH MORE!!

Here at Aeroflow, we are proud of our commitment to all of our employees. Aeroflow Health has been recognized both locally and nationally for the following achievements:

• Family Forward Certified
• Great Place to Work Certified
• Inc. 5000 Best Place to Work award winner
• HME Excellence Award
• Sky High Growth Award

If you’ve been looking for an opportunity that will allow you to make an impact, and an organization with unlimited growth potential, we want to hear from you!

Aeroflow Health is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

We value transparency and candidate safety throughout the hiring process. Aeroflow recruiters may reach out through platforms such as LinkedIn or Indeed; however, all interviews and/or offer coordination and sensitive information requests will occur only through our official communication channels. You will never be asked to provide personal data outside our secure application portal, and all interview or offer details will come from an @aeroflowinc.com email address. We do not conduct interviews via text message or instant-messaging apps. If you have concerns, please contact our Talent Acquisition team for verification