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LPN/RN Skilled Nursing Auditor
A company is looking for a Skilled Nursing Facility (SNF) Auditor III. Key Responsibilities Conduct in-depth clinical reviews to verify SNF billing accuracy Analyze claims under PDPM, RUG, and per diem payment models to identify overpayments Document audit findings using tools and guidelines while staying updated on clinical regulations Required Qualifications LPN or RN with an Associate's or Bachelor's degree preferred 3+ years of skilled nursing experience, with RAC certification or MDS coordinator experience as a plus Familiarity with PDPM, RUG, Medicaid 48 grouper reimbursement, and HIPPS codes billing
A company is looking for a Skilled Nursing Facility (SNF) Auditor III.
Key Responsibilities
Conduct in-depth clinical reviews to verify SNF billing accuracy
Analyze claims under PDPM, RUG, and per diem payment models to identify overpayments
Document audit findings using tools and guidelines while staying updated on clinical regulations
Required Qualifications
LPN or RN with an Associate's or Bachelor's degree preferred
3+ years of skilled nursing experience, with RAC certification or MDS coordinator experience as a plus
Familiarity with PDPM, RUG, Medicaid 48 grouper reimbursement, and HIPPS codes billing
