State Licensed Clinical Auditor

Job Summary

A company is looking for a Sr. Auditor Tl, Clinical Validation.

Key Responsibilities

• Conduct medical chart coding reviews and audits, focusing on ICD-10 coding principles
• Utilize proprietary auditing systems to generate audit determinations and documentation
• Achieve and maintain production goals while ensuring accuracy and quality in auditing processes

Required Qualifications

• Associate or Bachelor's Degree in Nursing (Active/Unrestricted License) or Health Information Management (RHIA or RHIT)
• At least one certification: RHIA, RHIT, CPC, COC, or Inpatient Coding Credential (CCS, CIC, CDIP, or CCDS)
• 1.5+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG
• Broad knowledge of medical claims billing/payment systems and coding terminology
• Proficiency in Microsoft Office Suite and other relevant applications