RN Claims Auditor: Healthcare Payment & Compliance

Direct Staffing Inc; Portland (OR); On-site; USD 70,000 - 90,000; Full time

Job summary

A prominent staffing organization is seeking a Nurse Auditor to conduct post-payment claims audits across multiple locations, including Portland. The ideal candidate will have extensive clinical expertise and qualifications, including an RN license and experience in skilled nursing or similar facilities. This role involves auditing, ensuring compliance with medical standards, and communicating results effectively.

Qualifications

• 5 years of hospital quality management, coding, or medical auditing experience.
• Current unrestricted RN license required.
• Certified Professional Coder preferred.

Responsibilities

• Plan, coordinate, conduct and report on post payment claims audits.
• Apply clinical expertise to ensure compliance with medical policies.
• Conduct coding audits and quality assurance assessments.

Skills

Medical and surgical procedures knowledge

Strong communication skills

Organizational skills

Analytical thinking

Education

Associate or Bachelor’s Degree in Nursing

Job description

A prominent staffing organization is seeking a Nurse Auditor to conduct post-payment claims audits across multiple locations, including Portland. The ideal candidate will have extensive clinical expertise and qualifications, including an RN license and experience in skilled nursing or similar facilities. This role involves auditing, ensuring compliance with medical standards, and communicating results effectively.