Clinical Auditor with Coding Certification

A company is looking for an Auditor Clinical Validation Outpatient Specialty Clinical. Key Responsibilities Audit outpatient and specialty claims using medical chart coding principles and client-specific guidelines Utilize advanced audit tools and maintain productivity and quality standards Identify new claim types and recommend improvements to enhance audit processes Required Qualifications Associate or bachelor's degree in nursing with an active/unrestricted license Coding certification (e.g., CPC, CIC, CCS) required and maintained 5 to 7 years of experience in clinical medical record coding or auditing Knowledge of HIPAA Privacy and Security Rules and medical claims billing systems Expert knowledge of coding guidelines, including DRG, ICD-10, CPT, and HCPCS codes