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Clinical Audit Analyst II - RN Licensed
VirtualVocationsOrange, California, United Statesjob_description.job_card.variable_days_ago
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- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Clinical Government Audit Analyst & Appeal Specialist II (Remote).
Key Responsibilities
Conduct thorough analyses of denials and ensure accurate coding while identifying overpayments and underpayments
Independently draft and submit comprehensive appeal letters to payors, ensuring compliance with relevant guidelines
Collaborate with clinical teams and management to identify denial patterns and develop strategies for appeals
Required Qualifications
Bachelor's degree in a work-related discipline / field from an accredited college or university
Minimum two (2) years of progressive denials and appeals experience
Knowledge of medical and insurance terminology, coding structures, and billing forms
Licensure or certification in coding or clinical documentation improvement required within 180 days
Proficiency in computer systems and software, including EPIC and Microsoft Office
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Audit Analyst • Orange, California, United States
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