It auditor Jobs in Clarksville, TN

A company is looking for a Medical Claims Review Auditor. Key Responsibilities : Analyzes claims that have failed established clinical-related adjudication parameters Establishes root cause of claims failure and determines appropriate resolutions Consults with various internal departments to resolve atypical issues and documents audit findings Required Qualifications : Bachelor's degree in Nursing with coding certification or equivalent combination of education and experience Minimum one year of medical claim auditing or medical record review experience for Registered Nurses Minimum two years of RN experience in a clinical setting for Registered Nurses Minimum seven years of direct coding experience for Certified Coders Successful completion of pre-employment background check and coding certification through AAPC or AHIMA