Medical Audit Specialist; Billerica, MA​/Middletown, CT

Overview

Enovis Corporation (NYSE: ENOV) is an innovation-driven medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, global talent and innovation, the Company's extensive range of products, services and integrated technologies fuels active lifestyles in orthopedics and beyond. For more information about Enovis, please visit

As a key member of the Revenue Cycle Management - Billing Operations team, you will play an integral role in advancing the medical technology industry by transforming patient care and improving patient outcomes.

Job Title: Medical Audit Specialist

Reports To: Manager, RCM Billing Operations

Location: Billerica, MA or Middletown, CT

Business Unit: RCM-Billing Operations

Role

Summary:

Are you detail-oriented and driven by accuracy and compliance in healthcare operations? We are seeking an Audit Specialist to support Revenue Cycle Management (RCM) audit requests and billing functions, and to collaborate with internal and external teams to resolve outstanding accounts receivable. This role is responsible for ensuring accurate charge capture, documentation, billing, and reimbursement in accordance with policies, payer guidelines, and regulatory requirements.

The Audit Specialist conducts reviews of clinical documentation and billing practices, identifies opportunities to enhance compliance, and responds to third-party payer and charge recovery audits, playing a key role in protecting revenue and supporting operational excellence.

• Demonstrates exceptional service and integrity related to customer accounts through accurate, timely, relevant, and quality work efforts of all Accounts Receivable or assigned tasks.
• Assists in the development and implementation of action plans to mitigate risk, pertaining to revenue cycle processes and billing compliance.
• Review and prepare audit documentation and submit it in a timely manner to the appropriate auditing entity.
• Weekly audit of insurance charges and manage AR escalations.
• Analyze denial trends and provide solutions for claim adjudication.
• Submit medical documentation related to the additional documentation request.
• Provide feedback to billing staff on coding issues and denials.
• Assist in training and education of coders and staff on compliance, billing, and coding principles for government and commercial payers.
• Prepares written reports and Power Points of audit performance, including recommendations and data points to improve compliance billing.

• Minimum of 5 years of experience in medical billing and collections required.
• Proficiency in Microsoft Office applications required.
• Knowledge of billing and collections regulations strongly preferred.
• Experience in a healthcare environment strongly preferred.
• Demonstrated customer service expertise.

This position does not require travel.

• Knowledge of insurance contract practices, third-party billing, and billing to private clients strongly preferred.
• Experience using Dataworks, Computers Unlimited TIMS, or similar third-party billing software strongly preferred.

Currently, Enovis does not provide sponsorship for employment visas (e.g., H-1B) and will not offer such sponsorship in the future. Applicants must already have full-time work authorization in the United States, both now and in the future, without requiring sponsorship.

What Creating Better Together Means We know that the power to create better - for our customers, our team members, and our shareholders - begins with having the best team, pursuing common goals, operating at the highest levels, and delivering extraordinary outcomes. Our purpose, values and behaviors are part of this commitment. Discover the why behind our purpose, values, and behaviors:
Our Enovis Purpose, Values and Behaviors on Vimeo.

• Medical Insurance
• Dental Insurance
• Vision Insurance
• Spending and Savings Accounts
• 401(k) Plan
• Vacation, Sick Leave, and Holidays
• Income Protection Plans
• Discounted Insurance Rates
• Legal Services

Enovis provides equal employment opportunities based on merit, experience, and other work-related criteria and without regard to race, color, ethnicity, religion, national origin, sex, age, pregnancy, disability, veteran status, or any other status protected by applicable law. We also strive to provide reasonable accommodation to employees' beliefs and practices that do not conflict with Enovis policies and applicable law. We value the unique contributions that every employee brings to their role with Enovis.

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