Performs clinical audit/validation processes to ensure that medical record documentation and billing for services rendered is complete, compliant and accurate to support optimal reimbursement
Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action
Validates and interprets medical record documentation to ensure billing for services is complete, accurate and follows all necessary guidelines
Applies clinical experience when conducting chart reviews of hospital and facility billing
Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed
Follows established guidelines/procedures
Requirements
Active Registered Nurse (RN) license
Minimum of 3+ years nursing experience
Able to apply analytical and critical thinking skills to reviews
MS Office proficiency
Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information
Ability to work independently, manage workload, and work in a production-based environment
Customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
Excellent writing, editing, interpersonal, planning, teamwork, and communications skills
Comfortable working in an ever-changing environment
Benefits
medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
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