Clinical Auditor

Aristo Sourcing • Other • Other (South Africa) • $300 - $400 / year • 1w ago

CLINICAL AUDITOR is responsible for reviewing and evaluating the quality of healthcare services provided by healthcare organizations. The job description typically includes:

The Clinical Auditor works closely with internal and external departments providing support to ensure a continuous flow of potential patients into all clinic locations.
The Clinical Auditor must be self-motivated, possess a strong work ethic, and a "can-do" attitude.
The Clinical Auditor is responsible for conducting detailed audits of clinical documentation, coding, and billing processes to ensure compliance with regulatory standards and internal policies.
The role requires a strong understanding of ICD-10 and CPT coding, as well as experience with major insurance providers including Medicare, Blue Cross Blue Shield, Aetna, and others. The ideal candidate must be able to work independently with a high level of attention to detail.
Conducting audits and assessments of clinical records, policies, and procedures to ensure compliance with regulatory requirements and industry standards.
Up-to-date with industry developments, regulations, and best practices to maintain expertise and provide guidance to healthcare organizations.

Requirements

Active Registered Nurse (RN) License (Preferably)
Strong knowledge of ICD-10 and CPT coding systems
In-depth industry knowledge regarding best practices, development, current regulations, and technology, particularly in Health Insurances such as Medicare, Blue Cross, Blue Shield, Aetna, and other insurance carriers
Deep background in a remote set-up of work similar to freelancing as an Independent Contractor (deep understanding of the pros & cons involved in this industry)
Exceptional attention to detail and analytical skills
Ability to work independently with minimal supervision
Strong organizational skills and ability to manage multiple tasks simultaneously
Excellent communication skills, both written and verbal
Experience in clinical audit, quality assurance, or healthcare compliance
Familiarity with electronic health record (EHR) systems and auditing software
Strong knowledge in healthcare compliance or auditing (e.g., CHC, CHCA) is a plus
Creative mindset with the ability to develop innovative engagement initiatives, ability to work independently and as part of a team
Flexible and able to perform multitasking in a fast-paced environment
High levels of professionalism and endurance under stressful conditions
Fast, reliable, and stable internet connection (LAN or Fiber) and internet backup

Benefits