State Licensed Clinical Auditor

Company: VirtualVocations
Location: Burlington
Posted on: May 2, 2025

Job Description:

A company is looking for a Sr Auditor TL, Clinical Validation.
Key Responsibilities

Conduct medical chart coding reviews and audits, focusing on ICD-10 coding principles and clinical guidelines
Utilize proprietary auditing systems to generate audit determinations and maintain productivity standards
Identify claims for potential recovery opportunities and contribute to process improvements and special projects

Required Qualifications

Associate or Bachelor's Degree in Nursing (Active/Unrestricted License) or Health Information Management (RHIA or RHIT)
At least one certification such as RHIA, RHIT, CPC, COC, or inpatient coding credentials (CCS, CIC, CDIP, or CCDS)
1.5+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG
Broad knowledge of medical claims billing/payment systems and coding terminology
Proficiency in Microsoft Office Suite and other relevant applications

Keywords: VirtualVocations, Arlington , State Licensed Clinical Auditor, Accounting, Auditing , Burlington, Massachusetts

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