RN Clinical QA Auditor

A company is looking for a Medical Review Clinical QA Auditor (RN) - Home Health & Hospice.

Key Responsibilities :

Conduct quality assurance reviews on medical review audit work to ensure accuracy and compliance with standards

Document quality review results and provide corrections or feedback based on audit findings

Monitor and report on audit activities and contribute to continuous improvement initiatives

Required Qualifications :

Current active unrestricted Nursing license (RN) in good standing

3+ years of diversified nursing experience providing direct care

2+ years of experience performing medical record audits in a provider or payer setting

5+ years of experience in health care claims with expertise in coding and medical billing

Thorough knowledge of medical documentation requirements and relevant regulations