Indiana Licensed Clinical Auditor

Job Summary

A company is looking for a Registered Nurse Clinical Auditor.

Key Responsibilities

• Review medical records and documentation for compliance with Indiana Health Coverage Programs and other regulations
• Conduct independent medical record reviews and provide preliminary findings
• Identify documentation deficiencies and assist with audit responses and appeals

Qualifications

• RN license preferred; Indiana or compact license accepted
• Coding certification such as CCS or CPC strongly preferred
• At least 1 year of experience in Medicaid claims review or healthcare reimbursement
• Familiarity with Indiana Medicaid policies and documentation requirements preferred
• Knowledge of CPT coding guidelines and ICD-10 standards