AnMed Health Clinical Audit Recovery Specialist in Anderson, South Carolina
The Clinical Audit Recovery Specialist is a credentialed nurse or credentialed coder who is responsible for performing chart reviews and clinical appeals as related to medical necessity, appropriateness of patient status and/or coding related to DRG assignment, APC assignment, units of service and providing education and guidance to practitioners and other team members. The Audit Specialist is capable of completing both coding and/or medical necessity reviews and appeals related to all patient types and governmental agencies as assigned.
Qualifications: RN with current SC license and a minimum two (2) years clinical experience required. Clinical audit and appeal experience preferred but not required. Bachelor's degree or higher preferred. Excellent communication skills, both written and oral, and computer experience required. Excellent organizational and time management skills required. Ability to work independently, meet deadlines and schedules required.