State Licensed Quality Auditor

Job Summary

A company is looking for a Senior Auditor Quality - OPSP.

Key Responsibilities

• Conducts clinical quality assurance reviews and communicates findings with initial auditors
• Applies healthcare auditing principles and performs independent medical audit activities
• Mentors other auditors and may flex into initial audit or appeals roles as needed

Required Qualifications

• Associates or Bachelor's degree in Nursing with an active/unrestricted license
• 5+ years of experience in claims auditing, quality assurance, or recovery auditing
• Required coding certification (e.g., RHIA, RHIT, CCS, or CIC)
• 3-5 years of healthcare auditing or related experience
• Ability to mentor staff and enhance auditor performance