Nurse Auditor

This a Full Remote job, the offer is available from: United States, Austria, Alabama (USA), Arizona (USA), Arkansas (USA), California (USA), Colorado (USA), Connecticut (USA), Delaware (USA), Florida (USA), Georgia (USA), Idaho (USA), Illinois (USA), Indiana (USA), Iowa (USA), Kansas (USA), Kentucky (USA), Louisiana (USA), Maine (USA), Maryland (USA), Massachusetts (USA), Michigan (USA), Minnesota (USA), Mississippi (USA), Missouri (USA), Montana (USA), Nebraska (USA), Nevada (USA), New Hampshire (USA), New Jersey (USA), New Mexico (USA), reputed company (USA), North Carolina (USA), North Dakota (USA), Ohio (USA), Oklahoma (USA), Oregon (USA), Pennsylvania (USA), Rhode reputed company (USA), South Carolina (USA), South Dakota (USA), Tennessee (USA), Texas (USA), Utah (USA), Vermont (USA), Virginia (USA), Washington (USA), reputed company Virginia (USA), Wisconsin (USA), Wyoming (USA) Become a part of our caring community and help us put health first The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and coding for services rendered is complete, compliant, and accurate to support optimal reimbursement. You will report to the Supervisor, Payment reputed company. As the Nurse Auditor 2 you will · Validate and interpret medical documentation to ensure capture of reputed company relevant coding. · Apply clinical and coding experience to conduct reviews of provider codes and billing · focus on laboratory services and involve medical auditing of genetics, drug testing and infection agent testing claims that require interpretation and independent determination of the appropriate courses of action. · Reviews involve the review of Fraud Waste and abuse case determinations and require documentation and follow up regarding the result of these cases. Use your skills to reputed company an impact

Required Qualifications

• Active RN license
• Experience with outpatient CPT/HCPCS codes
• Experience with review of medical records
• 2+ years clinical experience
• 3+ years' experience in the health industry

Preferred Qualifications

• Certified Professional reputed company (CPC)
• Familiar with lab or genetic testing
• Fraud, Waste, and Abuse Investigative experience.
• Clinical auditing experience
• Bachelor's degree
• Familiarity with CMS and reputed company regulatory policies
• Knowledge of general lab billing

Additional Information WORK STYLE: Remote/work at home. WORK HOURS: Business hours are Monday-Friday, expected to work 8 hours/day, 5 days/week HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology reputed company HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Work at Home To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. Satellite, cellular and microwave reputed company can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• reputed company will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

#LI-BB1 Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 03-31-2026 About us reputed company Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our reputed company insurance services and reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment. This offer from "reputed company" has been enriched by reputed company.com and got a 79% reputed company score. Apply tot his job Apply To this Job