Clinical Auditor - Cebu and Pasig
Cebu and Pasig, National Capital Region
Posted 5 days ago
- Company:
- Gratitude Philippines
- Company Description:
- We At Gratitude Philippines Are Able To Successfully Cater To The Recruitment And Staffing Requirements Of BPO Sector From Onshore To Offshore Locations.We Take Special Care Of Bpo Briefing Process To Gain Maximum Output From The Candidate And Everything The Company Has To Offer. Executive Search Gratitude Philippines Recruitment Services That Help Clients Reduce Cost And Time Associated With Hiring The Right Talent. We Understand That Human Resource Is The Pivotal Element In Success Of Any Business, Thus Our Focus Is On Finding Right Candidates Who Can Contribute To Our Client’s Success. Payroll Management & Staffing Our Comprehensively Vetted Recruitment Process Over 14 Years In The Industry Has Equipped Us To Recruit The Right Candidates For Your Company.Our Pan Philippines Presence And Contract Staffing Facilities Give Unparalleled Access To A Vast Base Of Candidates, Who We Rigorously Screen And Evaluate To Ensure The Right Fit Within Your Organization.
- Contract Type:
- Full Time
- Experience Required:
- 3 to 4 years
- Education Level:
- Bachelor’s Degree
- Gender:
- Any
- Number of vacancies:
- 1
Job Description
Responsibilities:
Perform regular audits of clinical practices, patient records, and healthcare processes.
Analyze audit findings and data to identify trends, patterns, and areas of risk.
Monitor the effectiveness of implemented changes and provide ongoing support.
Ensure that the organization complies with all relevant regulatory requirements.
Develop educational materials and resources to support ongoing staff development.
Required Skills:
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.
Possesses knowledge of healthcare claims payment policy and processing – specifically CMS, Medicaid regulations, ICD-10 CM & DRG Expert, etc.
Practical clinical experience working in a hospital/office or nursing home.
Has general knowledge of medical procedures, conditions, illnesses, and treatment practices.
Possesses excellent written and verbal communication skills. Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency.
Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.