Audit Technician – Denied Medical Claims

Position Summary

The Audit Technician for Denied Medical Claims is responsible for reviewing, analyzing, and reconciling denied healthcare claims to ensure accuracy, compliance, and timely resolution. This role supports the appeals and audit process by identifying errors, gathering documentation, and preparing claims for reconsideration. The Audit Tech works closely with auditors, nurses, and claims specialists to minimize financial loss and improve claim rates.

Key Responsibilities

• Review denied medical claims to determine reasons for denial (coding errors, missing information, medical necessity, eligibility, etc.).
• Collect, organize, and verify supporting documentation needed for appeals or audits.
• Prepare and submit claim audit packets for internal review or external payor reconsideration.
• Collaborate with clinical staff, coders, and billing teams to resolve discrepancies and correct claim data.
• Maintain accurat...