Let’s get started
Company Logo

Remote Jobs

Clinical Auditor with RN License

10/4/2025

N/A

Job Summary

A company is looking for a Clinical Auditor 2.

Key Responsibilities
  • Performs audits of medical records for denials review, defense audits, disallowed charges, and utilization reviews
  • Completes analysis of records against established criteria to determine compliance with patient condition and care standards
  • Organizes and prioritizes multiple cases, enters audit findings into the client's computer system, and composes appeal letters


Required Qualifications
  • RN/Case Management/Utilization Review/Coding or clinical certification with a BS/BA preferred, or equivalent technical experience
  • 3 to 5 years of clinical or clinical auditing experience in case management, Medicare appeals, or denials management
  • Knowledge of Milliman (MCG) or InterQual criteria preferred
  • Experience in medical records review, claims processing, or utilization/case management
  • Proficiency in Microsoft Outlook, Word, Excel, and navigating electronic documentation systems

Comments

No comments yet. Be the first to comment!