State Licensed Senior Auditor

Job Summary

Leading a team of Clinical Validation Auditors, the full-time State Licensed Senior Auditor will supervise audit activities, ensure quality outcomes, manage performance optimization, and provide training and support to team members in a remote work environment.

Key responsibilities

• Oversees audit team to ensure quality audit outcomes and adherence to clinical validation guidelines
• Optimizes team performance through training, process improvements, and monitoring of productivity and quality deliverables
• Acts as a resource for auditors, facilitating information sharing and addressing questions related to claims and clinical standards

Required qualifications

• Bachelor's degree in Health Information Management or nursing with an active/unrestricted license
• Coding or Clinical Documentation Certification required (e.g., CCDS, CPC, CIC, CCS, RHIA, RHIT)
• 2+ years of management or supervisory experience preferred
• 5+ years of experience in healthcare billing or claims management related to DRG and APC/ASC validation
• Computer proficiency in Microsoft Excel, Access, and system databases