Clinical Auditor

2 days ago


Pasig, National Capital Region, Philippines Solid Lyndelle Manpower Services Inc. Full time
Clinical Auditor Job Description

At Solid Lyndelle Manpower Services Inc., we are seeking a highly skilled Clinical Auditor to join our team. As a Clinical Auditor, you will be responsible for performing regular audits of clinical practices, patient records, and healthcare processes.

Key Responsibilities:
  • Conduct thorough audits of clinical practices, patient records, and healthcare processes to ensure compliance with regulatory requirements.
  • Analyze audit findings and data to identify trends, patterns, and areas of risk.
  • Monitor the effectiveness of implemented changes and provide ongoing support to ensure continuous improvement.
  • Develop and maintain knowledge of healthcare claims payment policy and processing, including CMS and Medicaid regulations.
  • Collaborate with healthcare professionals to ensure that the organization complies with all relevant regulatory requirements.
Requirements:
  • Registered Nurse with CIC/CCS certification and prior auditing/DRG experience preferred.
  • Experience in US Healthcare, medical coding, medical billing, RCM health plan operations strongly preferred.
  • Excellent written and verbal communication skills, with the ability to think logically and process sequentially with a high level of detailed accuracy and efficiency.
  • Strong knowledge of Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook.
What We Offer:

We offer a competitive salary range of $50,000 to $90,000 and a dynamic work environment with opportunities for growth and development.


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