Remote Clinical Audit Supervisor (Nursing)

Machinifyinc; United States; On-site; USD 85,000 - 110,000; Full time

Job summary

Machinify is seeking a Medical Review Audit Supervisor - Clinical to lead a remote team of nurses and audit professionals. You will guide clinical review audits, ensure adherence to guidelines, and support management with staffing, capacity planning, and quality standards.

The role requires a nursing license, significant auditing and claims coding experience, and the ability to mentor staff while driving cost-effective outcomes.

Qualifications

• Current active unrestricted Nursing license required.
• 3+ years nursing experience in inpatient/outpatient settings.
• 2+ years of medical record audits in payer/provider settings.
• 5+ years in health care claims with ICD coding and DRG experience.
• Supervisory or leadership experience in a similar environment.
• Experience with remote staff is a plus.

Responsibilities

• Perform clinical audits to maintain expertise and support business needs.
• Conduct audit quality assurance reviews and resolve rebuttals.
• Oversee audit determinations for consistency and quality.
• Lead remote audit staff and provide coaching and feedback.
• Monitor staffing, capacity planning, and productivity against SLAs.
• Collaborate with HR for corrective actions and training.

Skills

Leadership

Supervisory experience

Time management

Communication

Auditing

Remote team management

Problem solving

Data-driven decisions

Mentoring

Education

Registered nurse license

Tools

CPT/HCPCS/ICD-9/ICD-10 coding

MCS-1500/UB-04 forms

Encoder software

MS Office (Excel)

Job description

Machinify is seeking a Medical Review Audit Supervisor - Clinical to lead a remote team of nurses and audit professionals. You will guide clinical review audits, ensure adherence to guidelines, and support management with staffing, capacity planning, and quality standards.

The role requires a nursing license, significant auditing and claims coding experience, and the ability to mentor staff while driving cost-effective outcomes.