Home Health Auditor III

Job Summary

A company is looking for a Home Health Auditor III to ensure proper documentation and accurate billing in a remote capacity.

Key Responsibilities

• Audit Home Health medical records to validate or revise billed services based on CMS guidelines
• Apply clinical judgment and coding expertise to identify overpayments and ensure proper reimbursement
• Document audit findings clearly and professionally, utilizing industry-leading tools

Required Qualifications

• LPN or Registered Nurse with an Associate's or Bachelor's degree preferred
• 3+ years of acute care nursing experience, with preference for candidates holding OASIS or Coding certifications
• Prior experience in Home Health auditing is essential
• Deep knowledge of PDGM and PPS payment methodologies