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Senior Clinical Auditor

VirtualVocations
Chula Vista, CA Full Time
POSTED ON 3/4/2025
AVAILABLE BEFORE 5/25/2025

A company is looking for a Senior Auditor- Clinical Validation.Key ResponsibilitiesAnalyzes and audits claims using medical coding principles and clinical guidelinesUtilizes proprietary auditing systems to make determinations and generate audit lettersMaintains productivity and accuracy standards while identifying new claim types for potential recoveriesQualifications & RequirementsAssociate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT)Certification in coding / CDI (RHIA, RHIT, CPC, COC, CCS, CIC, CDIP, or CCDS)5 to 7 years of experience with ICD-9 / 10CM and medical claims billing / payment systemsExpert knowledge of coding guidelines and regulatory complianceProficiency in Word, Access, Excel, TEAMS, and other applications

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