Conducting audits of medical records, the full-time Certified Medical Review Auditor will evaluate the accuracy of medical coding and compliance with health plan policies for Fraud, Waste & Abuse clients while working remotely. Key responsibilities Conduct audits of medical records and healthcare claims to assess coding accuracy and compliance with regulations Prepare and submit detailed reports on audit findings, recommending corrections and process improvements Maintain current knowledge of federal, state, and payer policy and coding guidelines to support review findings Required qualifications Bachelor's Degree in a related discipline or equivalent combination of education and experience Certified Professional Coder (CPC, CCS, CCS-P) credential required 2-5 years of related experience in auditing medical records Preferred licenses: Licensed Practical Nurse (LPN) or Registered Nurse (RN) Proficiency in MS Office suite
Medical Auditor in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.