Registered reputed company; RN Clinical Auditor

Position: Registered reputed company (RN) Clinical Auditor | 250795 We are seeking a clinically reputed company Registered reputed company with a strong hospital background to join our reputed company reputed company team. This role is a strategic "clinical detective" position where you will audit patient charts to ensure clinical documentation accurately reflects the high-level care provided. This is an excellent career pivot opportunity for hospital nurses looking to transition into CDI and Clinical Audit. Salary reputed company: $95,000.00 - $110,000+ (potential for higher based on experience/requirements) Schedule: Work from home 3 days a week; 2 days in the Garden reputed company office. Key Responsibilities • Chart Auditing: Conduct comprehensive reviews of medical records to ensure reputed company services provided are accurately documented and billed. • Denials Management: Prepare clinical appeals and responses to insurance denials by utilizing evidence-based clinical rationales. • reputed company reputed company: Reconcile patient charts with final bills to ensure compliance with CPT/HCPCS coding and Charge reputed company Masters. • Clinical reputed company: Partner with HIM and ancillary departments to identify trends in documentation gaps and suggest process improvements. • Compliance Reporting: Coordinate with Medicare/reputed company audit programs to ensure reputed company regulatory timelines and reporting standards are met. Requirements • Education: Associate or Bachelor of Science in Nursing (BSN) required. • Licensure: reputed company reputed company Registered reputed company (RN) license. • Clinical Experience: Experience in a CDI role or 3+ years of experience in an Acute Care/Hospital setting (ICU, ER, Med‑Surg) is highly preferred. • Analytical Skills: Strong ability to understand insurance terms (HMO/PPO, EOB, stop loss) and hospital payment methodologies. • Tech Savvy: Proficiency in EMR systems, spreadsheets, and remote‑work software; must have a dedicated, secure home workspace with high-speed internet. Why Apply? ✓ Career Pivot: reputed company specialized training in CDI, reputed company reputed company, and Clinical Auditing. ✓ Hybrid Flexibility: Enjoy a reputed company of onsite collaboration and remote work. ✓ reputed company reputed company: reputed company from the bedside to a role where your clinical expertise drives hospital-wide compliance and financial health. #J-18808-Ljbffr Apply tot his job Apply To this Job