Clinical Defense Auditor

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The Clinical Defense Auditor will collaborate clinically with the patient care team and third parties to determine appropriateness and medical necessity of emergency care, admissions and specialty referrals.

Roles Responsibility
Compare and analyze billed charges to clinical records, Demonstrate clinical expertise, Coordinate chart reviews and problem identification, Extract data for reporting, Develop statistical analysis of findings, Request and validate service authorization, Collaborate on discharge planning, Communicate with payers and healthcare team, Identify and improve processes impacting customer service
Desired Qualification
BSN Bachelor of Science in Nursing
Type
Full Time
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