Job Summary
A company is looking for a Clinical Quality Assurance Nurse Auditor.
Key Responsibilities
- Evaluate clinical information and write/review various reports such as Medical Record Reviews and Coding Reviews
- Perform quality assurance reviews of peer reports and ensure compliance with client specifications and regulatory standards
- Identify inconsistencies in reports and assist in resolving customer complaints and quality assurance issues
Required Qualifications
- Bachelor's or Associate degree in nursing or related field, or equivalent experience
- Minimum five years of related experience or equivalent combination of education and experience
- Experience with medical terminology, medications, and treatment protocols
- RN or LPN license required
- Experience in the insurance industry preferred
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