RN Clinical QA Auditor

Performant Corporation; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

A healthcare company is seeking a Medical Review Clinical QA Auditor (RN) for remote work. The role involves conducting quality audits, documenting results, and providing feedback based on audit findings. Candidates must have an active RN license, extensive nursing experience, and expertise in medical record audits and healthcare claims. This opportunity is ideal for professionals looking to contribute to quality improvement in home health and hospice services.

Qualifications

• Current active unrestricted Nursing license (RN) in good standing.
• 3+ years of diversified nursing experience providing direct care.
• 2+ years of experience performing medical record audits.

Responsibilities

• Conduct quality assurance reviews on medical review audit work.
• Document quality review results and provide feedback.
• Monitor and report on audit activities.

Skills

Nursing experience

Medical record audits

Health care claims expertise

Knowledge of medical documentation

Education

Active RN license

Job description

A company is looking for a Medical Review Clinical QA Auditor (RN) - Home Health & Hospice.

Key Responsibilities:

• Conduct quality assurance reviews on medical review audit work to ensure accuracy and compliance with standards
• Document quality review results and provide corrections or feedback based on audit findings
• Monitor and report on audit activities and contribute to continuous improvement initiatives

Required Qualifications:

• Current active unrestricted Nursing license (RN) in good standing
• 3+ years of diversified nursing experience providing direct care
• 2+ years of experience performing medical record audits in a provider or payer setting
• 5+ years of experience in health care claims with expertise in coding and medical billing
• Thorough knowledge of medical documentation requirements and relevant regulations