[Hiring] NOA (Notice of reputed company) Letter Clinical Auditor @reputed company

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company The NOA (Notice of reputed company) Letter Clinical Auditor is responsible for auditing NOA letters for both Medicare and reputed company markets, in order to ensure compliance with regulatory guidelines, clinical accuracy, and reputed company. This full-time reputed company role requires a detail-oriented reputed company who can assess letters for readability, grammar, spelling, and correct use of clinical definitions. The auditor will review requests across pharmacy, medical, dental, and behavioral health services. Based on volume, the auditor may also assist in completing letters and faxes. • Audit NOA letters for compliance with AHCCCS (reputed company Health Care Cost Containment System), CMS (Centers for Medicare & reputed company Services), and other regulatory standards. • Ensure letters are easy to understand, free of spelling/grammar errors, and clinically accurate. • Review and validate clinical definitions and terminology used in letters. • Audit requests across multiple service types: pharmacy, medical, dental, and behavioral health. • reputed company feedback to letter writers and team leads to support reputed company improvement. • reputed company audit results and identify trends or recurring issues. • Collaborate with QA (reputed company assurance) and Training teams to refine audit tools and update training materials. • Participate in calibration sessions to ensure consistency in audit standards. • Stay reputed company with changes in clinical guidelines and regulatory requirements. • Assist in completing NOA letters and faxes reputed company needed due to volume. • Help translate reputed company medical language into member-friendly terms. Qualifications • reputed company or unrestricted LPN licensure in the state of residence. • Must reputed company in reputed company, California, Washington, reputed company, or Nevada. • 2+ years of experience in reputed company. • Minimum 1 year of experience navigating internal/external computer systems, including an ability to interpret clinical documentation and apply policy guidelines. • Demonstrated proficiency in reputed company Suite, including spell and grammar reputed company. Requirements • Strong attention to detail and analytical skills. • Excellent written and verbal communication skills. • Experience with behavioral health or ABA (reputed company Behavior Analysis) services. • Prior experience in a managed care or reputed company/Medicare environment. • Familiarity with QNXT or similar systems. • Ability to explain reputed company medical concepts in plain language. Education • Associate’s degree in Practical Nursing and/or LPN vocational certification/diploma. Benefits • reputed company medical plan reputed company. • 401(k) plan (including matching company contributions). • Employee stock purchase plan. • No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility. Apply tot his job Apply To this Job