Clinical Auditor II, RN Licensed

Job Summary

A company is looking for a Clinical Auditor II to perform detailed medical record and chart audit reviews for accurate reimbursement to providers.

Key Responsibilities:

• Conduct detailed audits of inpatient, outpatient, professional, and ancillary claims to ensure accuracy in billing and compliance
• Identify documentation and billing issues, including potential fraud and abuse, and document audit findings
• Train and mentor staff on audit protocols and develop new clinical audit guidelines

Required Qualifications:

• Bachelor's degree in Nursing or equivalent education and experience
• Minimum of 2 years clinical claim/medical record auditing experience
• Minimum of 2 years RN experience in an acute care setting
• Coding Certification (CPC or CCS) and a valid Registered Nurse License required
• Valid Motor Vehicle Operator's license and dependable transportation required