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Clinical Auditor
A company is looking for a Clinical Auditor. Key Responsibilities Review and analyze complex inpatient and outpatient charges, identifying billing abnormalities and improper coding Document audit results, assist management in operations, and identify recovery opportunities Apply national coding standards to claims and communicate findings to co-workers and management Required Qualifications Bachelor's degree preferred with at least 5 years of coding experience Minimum 5 years experience in medical procedure billing, auditing, or reimbursement Extensive knowledge of inpatient/outpatient hospital billing and coding standards Experience with payer reimbursement policies and medical necessity criteria Proficiency in MS Office Suites, particularly Excel, Outlook, and PowerPoint
A company is looking for a Clinical Auditor.
Key Responsibilities
Review and analyze complex inpatient and outpatient charges, identifying billing abnormalities and improper coding
Document audit results, assist management in operations, and identify recovery opportunities
Apply national coding standards to claims and communicate findings to co-workers and management
Required Qualifications
Bachelor's degree preferred with at least 5 years of coding experience
Minimum 5 years experience in medical procedure billing, auditing, or reimbursement
Extensive knowledge of inpatient/outpatient hospital billing and coding standards
Experience with payer reimbursement policies and medical necessity criteria
Proficiency in MS Office Suites, particularly Excel, Outlook, and PowerPoint
