Join PRIDE Health as a Travel Nurse RN Clinical Document Improvement Specialist and play a crucial role in ensuring healthcare compliance and fraud prevention while enjoying competitive weekly pay and comprehensive benefits.
Key Responsibilities
Review medical records to validate clinical and coding assessments
Conduct audits of high-risk claims and billing patterns
Assist in preparing documentation for audits and regulatory inquiries
Collaborate with SIU team members to evaluate suspected cases of fraudulent activities
Required Qualifications
5 years of healthcare fraud detection, investigation, or auditing
In-depth experience and knowledge of coding regulations including ICD-10, CPT, HCPCS, AMA