RN Clinical Auditor

Job Summary

A company is looking for an RN Clinical Auditor.

Key Responsibilities

• Perform clinical audit reviews for government and commercial payers to ensure compliance and quality standards
• Analyze medical records and data to identify trends and discrepancies, preparing audit materials as needed
• Collaborate with healthcare providers and educate staff on audit outcomes and best practices

Required Qualifications

• Associates or Bachelor's Degree in Nursing
• Registered Nurse (RN) license required
• 3 years of regulatory audit experience, utilization review, or clinical validation preferred
• Experience with electronic medical records (EMR) systems
• Ability to manage time and adapt to changing regulations in a production-based environment