Remote Senior Audit Recovery Payment Integrity Clinical Consultant in Madison

Job ID: Available for Members

Location: Wisconsin

Compensation: To Be Discussed

Staff Reviewed: Wed, May 13, 2020

This job expires in 7 days

Job Category: Consulting, Healthcare

Telecommute Level: 100% Telecommute

Travel Requirements: No Travel

Weekly Hours: Day Shift, Full Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Education Level: Some College

Additional Information: Benefits Available

Job Summary

A healthcare provider is in need of a Remote Senior Audit Recovery Payment Integrity Clinical Consultant in Madison.

Individual must be able to fulfill the following responsibilities:

  • Conduct extensive audits on a project basis: generate response letter for review by medical director
  • Investigate, research, and analyze claims data applying knowledge of medical or pharmacy policy
  • Identify and document fraudulent or erroneous activity during an audit

Skills and Requirements Include:

  • Bachelor’s Degree in Nursing required OR
  • Associate’s Degree with 2 or more years of additional experience may be substituted in lieu of a bachelor’s
  • 4+ years of ICD-9, ICD10 coding experience and medical review of Medicare claims
  • 4+ years associated business experience with Medicare policies and regulations
  • Strong knowledge of the Medicare policies, CMS NCDs, LCDs and Articles