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Home Health Auditor NurseVirtualVocations • Boca Raton, Florida, United States
Home Health Auditor Nurse

Home Health Auditor Nurse

VirtualVocations • Boca Raton, Florida, United States
3 days ago
Job type
  • Full-time
Job description
Working remotely in a full-time capacity, the Home Health Auditor Nurse will perform medical claims audit reviews, focusing on the Home Health sector, while collaborating with a team to ensure compliance with medical review guidelines and support during the appeals process. Key Responsibilities: Auditing claims for medically appropriate services and documenting findings according to established guidelines Generating letters to articulate audit findings and supporting those findings during appeals if necessary Collaborating with the audit team to identify vulnerabilities and improve audit workflows Required Qualifications: Active/unrestricted RN license with an associate or bachelor's degree in nursing Minimum of 2 years of experience in Home Health claims auditing or related fields Strong knowledge of ICD-9, ICD-10, CPT-4, or HCPCS coding Experience with utilization management systems or clinical decision-making tools Ability to work independently and efficiently in a remote environment
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Home Health Auditor Nurse • Boca Raton, Florida, United States

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