Clinical Nurse Coding Auditor (Part-time, Remote)

We are seeking an experienced Clinical Nurse Auditor to join our Payment Integrity team. In this role, you will leverage your clinical expertise, medical coding proficiency, and auditing skills to identify, monitor, and analyze unusual utilization patterns and potential fraud by healthcare providers.

Requirements

• Registered Nurse (RN) with coding certifications such as CPC (Certified Professional Coder), CIC (Certified Inpatient Coder), CDI (Clinical Documentation Improvement), or a similar credential, through AAPC or AHIMA
• Knowledge of commercial insurance plans, Medicare, and Medicaid programs
• Minimum 5 years of clinical nursing experience
• Prior experience with healthcare fraud investigation and auditing is highly preferred

Benefits

• Retirement Plan
• 401k Matching
• Paid Time Off