Clinical Auditor RN Licensed

Key responsibilities: Audits outpatient and specialty claims using medical chart coding principles and client-specific guidelines Effectively utilizes audit tools and maintains productivity and quality standards Identifies new claim types and recommends process improvements based on extensive healthcare auditing experience

Required qualifications: Associate or bachelor's degree in nursing with an active/unrestricted license Coding certification (e.g., CPC, CIC, CCS) 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 coding knowledge in DRG, ICD-10, CPT, and HCPCS codes