Clinical Auditor
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Job Description
Clinical Auditor role reviewing medical records and ensuring compliance with reimbursement guidelines. Ideal for experienced RN skilled in PDPM and ICD-10 coding in a remote setting.
Responsibilities:
- Perform chart scrubbing and clinical documentation audits to ensure completeness and accuracy.
- Review records to validate ICD-10 diagnosis coding and supporting clinical documentation.
- Ensure compliance with PDPM (Patient-Driven Payment Model) and CMS guidelines.
- Identify documentation gaps that may impact coding, reimbursement, or compliance.
- Prepare audit findings and provide recommendations for documentation improvement.
- Collaborate with clinical, coding, and compliance teams to resolve discrepancies.
Requirements:
- Active U.S. Registered Nurse (RN) license with New York State license required.
- 3+ years of experience in skilled nursing, long-term care, or post-acute settings.
- Strong knowledge of PDPM reimbursement and ICD-10 coding.
- Experience with clinical audits, chart review, or documentation improvement.
- Familiarity with MDS assessments and SNF documentation standards.
- Excellent analytical, documentation review, and communication skills.
Benefits:
- Flexible working environment
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