Registered Nurse Clinical Auditor

Job Summary

A company is looking for a Clinical Compliance Auditor.

Key Responsibilities

• Audit medical records to ensure compliance with coding, documentation, and regulatory standards
• Review and appeal clinical validation denials from third-party payers and government entities
• Provide education and support to staff regarding documentation, coding, and reimbursement issues

Required Qualifications

• Graduate from an accredited School of Nursing
• Registered Nurse (Single State) or RN - Multi-state Compact required
• Minimum 5 years of healthcare experience
• At least 1 year of experience with clinical validation denials/appeals or clinical validation auditing
• Proficient in Microsoft products, including Excel and Word