Clinical Auditor (Remote)

Niva Health; South Africa; Remote; ZAR 200 000 - 300 000; Full time

Job summary

A healthcare organization is seeking a Clinical Auditor to ensure compliance and accuracy in patient documentation and coding. This remote full-time position involves conducting internal audits, reviewing billing practices, and providing training to staff. Ideal candidates are Registered Nurses or Enrolled Nurses with experience in ICD-10 and CPT coding. Join a supportive team that values teamwork and quality in patient care.

Qualifications

• Registered Nurse or Enrolled Nurse preferred.
• Highly experienced in ICD‑10 and CPT coding and insurance billing.
• Sharp eye for detail and love tracking down inconsistencies.

Responsibilities

• Conduct internal audits of clinical documentation for accuracy and compliance.
• Review billing practices for major payers like Medicare and Aetna.
• Produce clear, concise audit reports for leadership.

Skills

ICD-10 and CPT coding

Insurance billing

Attention to detail

Communication skills

Education

Registered Nurse or Enrolled Nurse

Tools

EHR systems

Job description

Bring Order, Precision & Compliance to Patient Care

Are you a natural problem-solver who thrives in the details? Do you have a deep respect for structure, accuracy, and doing things the right way—especially when it comes to patient care, documentation, and compliance? If you're an experienced RN or clinical professional with strong auditing and coding chops, we want to speak with you.

At NIVA Health, we’re looking for a Clinical Auditor who can dig deep, spot inconsistencies, ensure compliance, and help us continuously raise the bar for quality in every patient chart and process.

What You'll Be Doing

This isn't just reviewing boxes and checking codes. You'll be a critical link between our clinical, operational, and billing teams—ensuring our documentation and coding not only meet but exceed industry and insurance standards. You'll educate teams, flag potential risks, and guide improvements with clarity and confidence.

In this role, you'll:

• Conduct internal audits of clinical documentation for accuracy and compliance with ICD‑10/CPT coding.
• Review billing practices for Medicare, Aetna, BCBS, and other major payers.
• Identify discrepancies and provide recommendations to fix them.
• Educate and train providers and staff on documentation best practices.
• Stay ahead of changes in coding standards and payer requirements.
• Produce clear, concise audit reports for leadership.
• Work independently from your home, managing your own schedule and priorities.

Requirements

You're a great fit if you:

• Registered Nurse or Enrolled Nurse (preferred).
• Are highly experienced in ICD‑10 and CPT coding and insurance billing.
• Know the ins and outs of Medicare, BCBS, Aetna, and other big players.
• Have a sharp eye for detail and love tracking down inconsistencies.
• Thrive working independently in a quiet, remote setting.
• Communicate clearly, tactfully, and effectively—whether in reports or training sessions.

Bonus points if you:

• Have experience in clinical auditing, compliance, or quality assurance.
• Are familiar with EHR systems and audit tools.
• Hold a relevant certification (like CHC or CHCA).

Why join us?

At NIVA Health, we live our Core Values—Teamwork, Resilience, Open‑Mindedness, Ownership, and Positivity—every day. You'll be joining a team that truly cares, takes pride in doing meaningful work, and supports each other while striving for excellence. Your insights will help us provide better care to more people, more efficiently.

Job Type: Full‑time

Work Location: Remote