Senior Auditor Quality - DRG

Overview

Employer Industry: Healthcare Auditing

• Salary up to $56.00 per hour
• Competitive benefits package, including medical, dental, vision, disability, and life insurance
• 401(k) savings plans and paid family leave
• Generous Paid Time Off (PTO) ranging from 17 to 27 days per year based on service
• Opportunity to mentor and enhance the performance of auditing staff
• Flexible working conditions with the ability to create a dedicated, secure work area at home

• Conduct clinical quality assurance reviews of daily clinical validation audits and communicate findings with initial auditors
• Apply healthcare auditing principles with objectivity during medical audit activities and reviews
• Independently perform audits and review the work of others for accuracy and compliance
• Assess medical records for medical necessity, billing/coding issues, and quality concerns
• Mentor junior QA auditors and potentially flex into initial audit or appeal roles as required by business needs

• Education:
  
  Associate's or Bachelor's degree in Nursing (active/unrestricted license) or Health Information Management (RHIA or RHIT)
• Minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing, preferably in a DRG/Clinical Validation Audit setting or hospital environment
• Required coding certification, such as RHIA, RHIT, or inpatient coding credentials (CCS or CIC preferred)
• 3-5 years of relevant healthcare auditing or related experience
• Strong verbal and written communication skills with proficiency in Microsoft Office Suite

• Inpatient coding certification (CCS or CIC) or the ability to obtain one within one year of hire
• Previous mentoring experience in a healthcare auditing environment
• Familiarity with clinical validation and DRG auditing processes

#Healthcare Auditing #Quality Assurance #Career Opportunity #Competitive Pay #Mentorship

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