Auditor Clinical Validation Outpatient Specialty Clinical

This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused on one of the following disciplines from a coding and billing perspective: SNF, IRF, Home Health, APC, ER, Diagnostics and Professional Service. This position is responsible for auditing outpatient/specialty claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, medical necessity, and the appropriateness of treatment setting, and services delivered. Requires expert coding knowledge - DRG, ICD-10, CPT, HCPCS codes. Excellent verbal and written communication skills. Ability to work well in an individual and team environment.