Licensed Practical Nurse Audit Specialist

Job Summary

Supporting the Denials Management Team, the full-time remote DMT Clinical Records & Audit Support Specialist will coordinate and compile clinical and administrative records for Medicaid audits and Part B physician services requests while ensuring accurate documentation and compliance with regulatory guidelines.

Key responsibilities

• Coordinate and compile records for Medicaid audits and Part B physician services requests
• Review documentation requests to identify necessary records and organize them for submission
• Communicate with agency staff and clinical personnel regarding outstanding records and due dates

Required qualifications

• Current Licensed Practical Nurse (LPN) license preferred or substantial clinical knowledge/healthcare experience
• Experience in Medicaid Home Health, Hospice, or Part B physician services strongly preferred
• Clinical knowledge to recognize common medical record components and supporting documentation
• Previous experience with healthcare audits and medical record requests preferred
• Proficiency with Microsoft Office and experience navigating electronic medical records systems