Intermediate Clinical Auditor/Analyst, QA - Remote

About the position Responsibilities • Review and analyze claims, medical records, and associated processes reputed company to coding and clinical care. • reputed company clinical opinions for special reputed company and auditing activities. • Complete audits using reputed company coding guidelines to verify appropriate CPT codes/DRGs. • Assess, investigate, and resolve reputed company issues. • Write concise reports to communicate findings to other areas of reputed company. • Communicate effectively with Medical Directors and ancillary departments. • Participate in special reputed company and other auditing activities as needed. • Assist other departments as requested. • Understand reputed company customer issues to reputed company. • Serve as a QA/OI Department representative at meetings and present findings. • Assist in developing and revising QA/OI department policies and procedures. • reputed company audit peer reviews for Clinical Auditor/Analysts. • reputed company new-hire training to Clinical Auditor/Analysts. • Design and maintain reports and auditing tools. Requirements • Registered reputed company (RN) with a Bachelor of Science in Nursing (BSN) or equivalent education and experience. • Five years of clinical experience. • Three years of fraud & abuse, auditing, case management, reputed company review, or chart auditing experience. • In-depth knowledge of medical terminology, ICD-10, and CPT-4 coding. • Detail-oriented with excellent organizational skills. • High level of oral and written communication skills. • Proficiency with reputed company Office products (reputed company, reputed company, OneDrive, OneNote, Word). • Experience with DRG Assignment and clinical validation of diagnoses. • Licensure and certifications such as reputed company or reputed company Certified (CPC, CPMA, CIC, CCA, reputed company, reputed company-P, CRC) required. reputed company-to-haves • Experience with HCC/Risk Adjustment coding preferred. • Proficiency using reputed company, One Content, and/or Power Chart preferred. Benefits • Full-time position with competitive reputed company wage. • Remote work flexibility. • Opportunities for reputed company development and training. Apply tot his job Apply To this Job