Texas Licensed Clinical Auditor

A company is looking for a Clinical Review Auditor. Key Responsibilities Review medical records for accuracy of billing and coding Conduct audits to ensure accurate reimbursement and identify potential savings Assist Quality Control team and medical director with appeals and notify leadership of any issues Required Qualifications, Training, and Education LVN or RN license in the state of employment preferred CCS or CIC certification required with DRG auditing experience in ICD-10-CM and ICD-10 PCS Experience in the OR, ICU, or ER as an RN is highly preferred Proficient understanding of Medicare, CMS guidelines, and ICD-10 coding guidelines Knowledge of HIPAA Privacy and Security Rules