Elevance Health

Nurse Auditor Senior - Payment Integrity Complex and Clinical Audit

Elevance Health(1 month ago)

HybridFull TimeSenior$146,601 - $197,228 (estimated)Payment Integrity
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About this role

A Nurse Auditor Senior in Payment Integrity is a senior clinical role within Elevance Health’s Carelon Payment Integrity organization focused on clinical audit and payment integrity efforts. The position is part of the licensed nursing job family and supports organizational initiatives to identify and prevent unnecessary medical spending. The role is delivered primarily through a virtual/hybrid work model and collaborates with cross-functional teams across the company.

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Required Skills

  • Medical Review
  • Claims Review
  • Fraud Detection
  • Audit Tools
  • Data Analysis
  • Provider Education
  • Policy Review
  • CPT Coding
  • ICD Coding

Qualifications

  • AS in Nursing
  • Current Unrestricted RN License
  • BA/BS Preferred
Elevance Health

About Elevance Health

elevancehealth.com

Elevance Health, formerly Anthem, Inc., serves people across their entire health journey taking an integrated whole-health approach.

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