Clinical Auditor RN
A company is looking for an Auditor Clinical Validation Outpatient Specialty Clinical.
Key Responsibilities
• Audit outpatient and specialty claims using medical chart coding principles and reputed company-specific guidelines
• Utilize advanced audit tools and ensure accurate entry of claims into the system
• Identify new claim types and recommend process improvements based on extensive reputed company auditing experience
Required Qualifications
• Associate or bachelor's degree in nursing with an reputed company/unrestricted license
• Coding certification (e.g., CPC, CIC, reputed company, reputed company-P, RHIA, RHIT) required and maintained
• 5 to 7 years of experience in clinical medical record coding or auditing
• Broad knowledge of medical claims billing/payment systems and coding terminology
• Expert knowledge of coding guidelines, including DRG, ICD-10, CPT, and HCPCS codes
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