We're looking for a Medical Auditor, working in the Insurance industry in Albuquerque, New Mexico, United States.
Function as a Clinical Reviewer for HHS ACA risk adjustment and Medicare Advantage risk adjustment audits to inspect clinical records for the presence of documentation to support the validity of claims data submitted.
Discern when missing medical record gaps exist and assist in directing request for additional records.
Perform claims research and inspection.
The pay range we are offering is 34 to 35 per hour. This position may present an opportunity to go permanent.
Our client is a fast-growing industry-recognized staffing firm. Recruiting critical IT, Financial, Engineering, Healthcare, and Data Analytics talent. With 20+ years’ experience and growth.
Connections in Automotive, Healthcare, Retail, Financial & Insurance, and Professional & Business Services. Working to bring top talent together with premier organizations.
Big enough to have great opportunities. Small enough to care about finding the right one for you.
It’s about relationships based on mutual interest. The results are low turnover, long-lasting partnerships and growth. Want to work for a company invested in your success?
Experience Required for Your Success
Associates or Bachelor degree preferred
RN or LPN required from the State
Experience in clinical auditing or medical record review preferred
Familiarity with claims investigation or research helpful
What Do You Think?
Does your experience reflect what it takes to be successful in this role? Do the work and challenges get you excited about what's possible? Apply here.