Job Summary

A health insurance company needs applicants for an opening for a Remote Nurse Auditor.

Individual must be able to fulfill the following responsibilities:

• Validate and interpret medical documentation to ensure capture of all relevant coding
• Identify members with high risk CMS Hierarchical Condition Categories (HCC)
• Identify the root cause analysis of audit findings and submit recommendations for appropriate change management

Qualifications Include:

• Bachelor's Degree
• Active Registered Nurse (RN) license
• 3 or more years acute inpatient hospital coding experience or inpatient auditing experience
• Demonstrated ability to lead process/project initiatives