Medical Review Clinical Appeals Auditor – ALJ (SNF FOCUS)
Performant(2 months ago)
About this role
The Medical Review Clinical Appeals Auditor – ALJ (SNF FOCUS) conducts Appeals reviews of medical audits by analyzing new evidence provided by auditees. This role involves collaborating with the medical review clinical audit team and participating in Administrative Law Judge (ALJ) hearings as needed. The position also serves as a subject matter expert while achieving productivity and quality standards.
Required Skills
- Clinical Reviews
- Appeals Reviews
- Quality Assurance
- Data Analysis
- Medical Coding
Qualifications
- Active RN License
- 1+ Years Health Care Claims Experience
- 5+ Years Relevant Experience
About Performant
performantcorp.comPioneering Payment Precision Take control with our solutions, reclaim capital, restore integrity, and transform your financial future. Get Started Today Get Started Today The Premier Independent Healthcare Payment Integrity Company in the US Performant Healthcare Solutions® technology-enabled audit, eligibility, recovery and data analytics solutions are designed to help health plans identify improper payments and recoup […]
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