Licensed Medical Review Auditor

Job Summary

A company is looking for a Medical Review Auditor (Fraud Waste and Abuse).

Key Responsibilities

• Conduct audits of medical records and healthcare claims for accuracy and compliance
• Prepare and submit detailed reports on audit findings with recommendations for improvements
• Conduct medical policy research to support review findings

Required Qualifications

• Bachelor's Degree in a related discipline or equivalent education and experience
• Preferred licenses: Licensed Practical Nurse (LPN) or Registered Nurse (RN)
• Required Credential: Certified Professional Coder (CPC, CCS, CCS-P)
• 2-5 years of related experience in auditing medical records
• Computer proficiency in MS Office suite