State Licensed Senior Quality Auditor

Job Summary

To ensure high-quality recoverable claims, the full-time State Licensed Senior Quality Auditor will perform clinical quality assurance reviews, communicate audit findings, and mentor other auditors while working remotely.

Key responsibilities

• Conducts clinical quality assurance reviews and communicates discrepancies with initial auditors
• Applies healthcare auditing principles and objectivity during medical audit activities
• Mentors QA 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
• Relevant coding certification (RHIA, RHIT, CCS, or CIC preferred)
• 3-5 years of healthcare auditing or related experience
• Ability to mentor staff and enhance auditor performance