Senior Compliance Auditor
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Job Description
Senior Auditor responsible for clinical or physician compliance topics at Highmark Health. Leading audits and guiding auditors on compliance with Medicare and third-party payor requirements.
Responsibilities:
- Senior auditor responsible for clinical or physician compliance topics.
- Conducts educational sessions for hospital/physician staff.
- Conducts audits of Medicare/Medicaid and other third party payor accounts.
Requirements:
- Bachelor's degree in nursing
- 7 years in utilization review, case management, hospital/physician coding and documentation audits/reviews
- Experience with medical necessity denials/appeals
- RHIT, RHIA certification preferred
Benefits:
- Health insurance
- Paid time off
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