Remote Clinical Validation Auditor

Job Summary

A healthcare company has an open position for a Remote Clinical Validation Auditor.

Core Responsibilities of this position include:

• Drawing on advanced clinical expertise and industry knowledge to substantiate conclusions
• Meeting or Exceeding Standards/Guidelines for Productivity
• Identifying potential claims outside of the concept where additional recoveries may be available

Required Skills:

• Excellent written and verbal communication skills
• Associates or Bachelor's degree in Nursing (active / unrestricted license)
• Clinical experience required
• High level of proficiency in Milliman and Interqual guidelines
• Ability to utilize and analyze clinical auditing knowledge and skills
• Proficiency in Word, Access, Excel and other applications