Registered Nurse Clinical Auditor

To ensure accurate reimbursement and compliance with healthcare standards, the full-time remote Registered Nurse Clinical Auditor will perform detailed medical record audits, analyze clinical data, and develop comprehensive audit reports while collaborating with clinical staff and providers. Key responsibilities: Analyze patient records and medical billing documents for accuracy and compliance with healthcare regulations Verify proper coding of procedures and diagnoses using CPT, HCPCS, and ICD-10 codes Conduct audits and develop reports outlining findings, discrepancies, and actionable recommendations for improvement Required qualifications: Bachelor's degree in nursing or equivalent education and experience Two years of experience in case management, utilization management, claims auditing, or a similar clinical health insurance role Minimum of two years of RN experience in an acute care setting Behavioral Health and/or Inpatient DRG experience required Valid Registered Nurse License; coding certification (CPC or CCS) preferred