Auditor III - SNF RUG

Job Summary

A company is looking for an Auditor III - SNF / RUG.

Key Responsibilities:

• Conduct clinical reviews to verify the accuracy of skilled nursing facility billing
• Apply CMS clinical guidelines and payer-provider contract terms and policies to identify overpayments
• Document audit results accurately using applicable tools and guidelines

Qualifications:

• LPN or Registered Nurse with Associate's or Bachelor's degree preferred
• 3+ years of skilled nursing experience, preference for RAC certification or reimbursement/MDS coordinator
• Experience with RUG, PDPM Medicare reimbursement systems, and Medicaid 48 grouper reimbursement system
• Experience with billing HIPPS codes and days of billing for each assessment type