Licensed Nurse Auditor

Job Summary

Performing medical necessity reviews of clinical documentation, the full-time Licensed Nurse Auditor will ensure compliance with contracts and regulations while developing relationships with medical providers and health plans in a remote environment.

Key responsibilities

• Independently audit clinical documentation to ensure consistency with billed services
• Apply clinical and industry guidelines to support medical necessity of services rendered
• Develop relationships with medical providers and health plans to confirm adherence to policies and guidelines

Required qualifications

• An active RN or LPN professional license in good standing
• 5 years of clinical practice experience
• Well-developed verbal and written communication skills
• Ability to effectively prioritize tasks