Registered Nurse Clinical Auditor

Job Summary

A company is looking for an Auditor Clinical Validation (Place of Service, Short Stay & Readmission).

Key Responsibilities

• Analyze and audit claims based on clinical guidelines and medical chart severity
• Utilize proprietary auditing systems to make determinations and generate audit letters
• Maintain production goals and achieve accuracy and quality standards for audits

Required Qualifications

• Associate or Bachelor's degree in nursing
• Active RN License in the state of residence
• 5 to 7+ years of experience in Utilization Management or Case Management
• Critical Care background in areas such as ICU, Emergency Room, or Med Surg
• Proficiency in Word, Access, Excel, and TEAMS