Auditor, Clinical Validation, Outpatient Specialty
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Job Description
Auditor role focusing on Coding & Clinical Chart Validation for Outpatient and Specialty audits. Requires clinical nursing background and coding/auditing expertise for accurate claim auditing.
Responsibilities:
- Audits Outpatient and Specialty Claims utilizing medical chart coding principles
- Draws on advanced coding expertise and industry knowledge to substantiate conclusions
- Performs work independently, reviews and interprets medical records
- Utilizes advanced proficiency in Cotiviti encoder and audit tools
- Meets or exceeds standards/guidelines for productivity and quality
Requirements:
- Associate or bachelor’s degree in nursing (active /unrestricted license)
- Coding Certification required and maintained i.e. CPC, CIC, CCS, CCS-P, RHIA or RHIT
- 5 to 7 years of experience with clinical medical record coding or auditing
- Working knowledge of HIPAA Privacy and Security Rules and CMS security requirements
- Ability and desire to utilize base coding and clinical auditing knowledge
- Must have excellent verbal and written communication skills
Benefits:
- Medical, dental, vision, disability, and life insurance coverage
- 401(k) savings plans
- Paid family leave
- 9 paid holidays per year
- 17-27 days of Paid Time Off (PTO) per year
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