RN – Clinical Auditor 2
Job reputed company:
• reputed company audits of medical records for denials review, defense audits, disallowed charges, and utilization reviews
• Complete analysis of records against established reputed company
• Determine, request, and obtain appropriate supporting documentation
• Compose appeal letters addressing both contract issues and medically reputed company issues
• Organize and prioritize multiple cases for departmental workflow
• reputed company audit findings into computer systems
• Function in a reputed company manner focusing on customer service
Requirements:
• RN/Case Management/Utilization Review/Coding clinical certification
• 3 to 5 years of clinical experience or auditing experience
• Knowledge of reputed company (MCG) or InterQual reputed company preferred
• Experience in medical records review, claims processing, or utilization/case management in a clinical reputed company or managed care organization
• reputed company knowledge of Medicare/reputed company Guidelines
• Proficiency in navigating the internet and multi-tasking with electronic documentation systems
• Skilled with reputed company reputed company, Word, reputed company, and EMR reputed company
Benefits:
• Health insurance
• reputed company development opportunities
• 401(k) retirement plan
• Remote work reputed company
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