RN Clinical Auditor

📋 Description

• • The RN Clinical Auditor performs government, state, and commercial payer clinical audit reviews to ensure compliance, accuracy, and quality in healthcare billing and documentation, directly supporting revenue integrity and risk mitigation for hospitals and health systems.
• • Day-to-day responsibilities include reviewing medical records for compliance with CMS and payer regulations, validating services rendered, gathering documentation from EMR systems, preparing audit responses, analyzing data for trends, collaborating with clinical and administrative teams, educating staff on best practices, and assisting in developing action plans to prevent future audit findings.
• • Ensemble Health Partners is a national leader in technology-enabled revenue cycle management, recognized for excellence in healthcare financial performance and innovation, with a mission to keep hospitals healthy so communities can thrive.
• • In this role, you will deepen your expertise in healthcare compliance, regulatory standards, and clinical documentation while developing leadership skills through cross-functional collaboration, process improvement initiatives, and mentorship opportunities that support long-term career growth in clinical auditing and revenue integrity.