New Jersey Licensed Clinical Auditor

Job Summary

A company is looking for a Clinical Auditor - Remote.

Key Responsibilities

• Perform clinical validation audits and ensure accurate coding for Medicare Risk Adjustment reimbursement
• Compile detailed findings and prepare client reports following medical record audits
• Coordinate with clients to ensure proper processing of patient data for audits

Required Qualifications

• Associate Degree or equivalent from an accredited practical nursing program
• Valid nursing license (RN/LPN) and relevant coding certifications (CRN-C, CCS, CPC, RHIA, or RHIT) with coding experience
• Documentation Improvement experience and knowledge of Hierarchical Condition Categories (HCC)
• Experience with Medicare Advantage plans and managed health care systems
• Proficiency in MS Word, Excel, and PowerPoint; ability to learn new software