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Medicare Clinical Auditor - Boulder Colorado

Company: VirtualVocations
Location: Boulder, Colorado
Posted On: 11/19/2024

A company is looking for a Medicare Clinical Auditor.



Key Responsibilities

Audit outpatient, inpatient, and professional claims from a clinical and coding perspective
Document audit results, including denial reasons and erroneous activities
Review provider appeals and maintain knowledge of coding and billing guidelines


Required Qualifications, Training, and Education

Graduate of a registered nursing program or Bachelor of Science in a medical-related field
3+ years of experience as a Clinical Auditor or equivalent clinical and medical auditing experience
Certified Medical Auditor (must obtain within 18 months if not certified)
Knowledge of ICD codes, procedure codes, and industry standard billing rules
Intermediate skills in Microsoft Office and claims adjudication systems More...

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