Clinical Auditor 2

March 6

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Savista

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Savista is a full-service revenue cycle management provider with over 30 years of experience in the healthcare industry. They support healthcare organizations in improving financial outcomes by offering services such as AR management, denial management, clinical documentation integrity, eligibility & enrollment, and HIM outsourcing. Savista works as an extension of healthcare teams to optimize processes and increase efficiency to ensure compliance and drive patient-centered service quality. The company has garnered recognition and industry accolades for its effective and quality solutions.

Revenue Cycle Management • HIM • Patient Engagement • Revenue Integrity • Accounts Receivable Management

1001 - 5000 employees

Founded 1994

⚕️ Healthcare Insurance

📋 Description

• The Clinical Auditor 2 performs audits of medical records on behalf of hospital clients for denials review, defense audits, disallowed charges, and utilization reviews. • Audit and analysis must be accurate and consistently ensure a high level of quality, knowledge of laws, rules, regulations and guidelines necessary to ensure compliance and protection of information. • Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution. • Must communicate clearly in English. Requires the ability to speak, read, write, see, and hear to perform essential duties of the job. • Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession. • Must maintain confidentiality of patient information and abide by all HIPAA related guidelines.

🎯 Requirements

• RN/Case Management /Utilization Review/Coding or clinical certification with a BS/BA preferred otherwise equivalent years of technical experience • 3 to 5 years of clinical experience or 3 to 5 years of clinical auditing experience in either case management, Medicare appeals, utilization review or denials management • Knowledge of Milliman (MCG) or InterQual criteria preferred • Experience in medical records review, claims processing or utilization/case management in a clinical practice or managed care organization • Fundamental knowledge of Medicare/Medicaid Guidelines • Proficiency in navigating the internet and multi-tasking with multiple electronic documentation systems simultaneously (toggling) • Skilled with Microsoft Outlook, Word, Excel and EMR Savista