Job Summary
A healthcare technology solutions company has an open position for a Telecommute Senior Contract Compliance Auditor.
Core Responsibilities of this position include:
- Using established guidelines and healthcare experience as well as independent judgment based on nationally recognized auditing standards, payer contractual guidelines and payment policies to accomplish job responsibilities
- Analyzing, reviewing, and validating healthcare claim payments for implantable medical devices
- Communicating audit determinations in writing to the client, provider and appropriate business departments as determined by internal departmental workflow policies
Qualifications for this position include:
- Availability for occasional travel may be necessary
- Registered Nurse with current active license
- Clinical review experience
- Knowledge of healthcare contracts
- Demonstrated knowledge of healthcare billing, coding and reimbursement guidelines (Revenue Code, CPT4, HCPCS, and ICD-10)
- Demonstrate knowledge of implantable medical devices as they relate to surgical procedures
