State Licensed Audit Policy Analyst

Key responsibilities: Develop and update post-acute audit concepts based on regulatory changes and client-specific policies Perform quality assurance reviews and validate audit concepts against billing rules and guidelines Manage multiple audit workflows, ensuring consistent application of policies across auditing platforms

Required qualifications: Bachelor's degree in nursing, health administration, business, or a related field, or equivalent experience Minimum 5+ years of experience in DME, home health, and/or home infusion therapy with a focus on payment integrity and claims auditing Registered Nurse or Certified Coder holding a nationally recognized credential (RHIA, RHIT, AHIMA, AAPC, or equivalent) required Expert knowledge of post-acute coding systems and payment methodologies, including ICD-10-CM and HCPCS Level II Strong experience in data utilization and statistical analysis related to audit concepts