Clinical Auditor RN
Job is Expired
Location: Remote
Compensation: Salary
Staff Reviewed: Tue, Jul 30, 2024
Job Summary
A company is looking for a Clinical Auditor 2.
Key Responsibilities:
- Defending audits of medical records for denial review, disallowed charges, and utilization reviews
- Completing analysis of records for complex inpatient reviews, including DRG Downgrades and Medicare appeals
- Performing advanced reimbursement reviews and managing patient inquiries and charge hold audits
Required Qualifications:
- Must be a licensed RN
- 3 to 5 years of hospital/clinical experience
- Knowledge of MCG and/or InterQual criteria
- Experience in medical records review, claims processing, or utilization/case management
- Fundamental knowledge of Medicare/Medicaid Guidelines
COMPLETE JOB DESCRIPTION
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Job is Expired
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