job description
Join Kavi Software Technologies Philippines Corp., a leading provider of innovative healthcare solutions, as a Clinical Nurse Auditor (USRN) and play a pivotal role in ensuring the highest standards of patient care and compliance. This remote position, based in the stunning island of Bali, Indonesia, offers the perfect blend of professional growth and tropical lifestyle in locations like Canggu, Ubud, Denpasar, Jimbaran, Nusa Dua, Kuta, or Badung.
As a Clinical Nurse Auditor, you will leverage your clinical expertise to evaluate healthcare services, admission statuses, and coverage determinations with precision and compassion. Your keen judgment will directly impact patient outcomes and operational efficiency, making this role both challenging and rewarding. This position is ideal for a detail-oriented nursing professional who thrives in a dynamic, remote work environment while contributing to the global healthcare landscape.
At Kavi Software Technologies, we value collaboration, innovation, and excellence. You’ll work alongside a diverse team of healthcare professionals, utilizing cutting-edge technology to streamline auditing processes and enhance patient care. Enjoy the flexibility of remote work without compromising on career advancement opportunities, competitive compensation, and a supportive work culture.
If you are a US Registered Nurse (USRN) with a passion for clinical auditing and a desire to make a meaningful difference, we invite you to apply. Embrace the opportunity to grow your career while enjoying the unparalleled beauty and culture of Bali.
Responsibility
- Conduct thorough reviews of medical records to assess the appropriateness of services, admission statuses, and level of care provided to patients.
- Apply clinical judgment to evaluate coverage determinations, ensuring compliance with healthcare policies and regulations.
- Collaborate with healthcare providers to clarify documentation and improve the accuracy of clinical records.
- Identify trends and discrepancies in clinical data, providing actionable insights to enhance patient care and operational efficiency.
- Prepare detailed audit reports, highlighting findings and recommending corrective actions to stakeholders.
- Stay updated on healthcare regulations, industry standards, and best practices to ensure audits are conducted with the highest level of accuracy.
- Participate in training sessions and workshops to educate healthcare teams on documentation improvements and compliance requirements.
- Maintain confidentiality and integrity of patient information in accordance with HIPAA and other regulatory guidelines.
Qualifications
- Active US Registered Nurse (USRN) license with a minimum of 3 years of clinical experience in a healthcare setting.
- Proven experience in clinical auditing, utilization review, or case management is highly desirable.
- Strong understanding of healthcare regulations, including Medicare, Medicaid, and private insurance guidelines.
- Excellent analytical skills with the ability to interpret complex medical data and documentation.
- Proficiency in electronic health record (EHR) systems and Microsoft Office Suite (Word, Excel, PowerPoint).
- Exceptional communication skills, both written and verbal, with the ability to collaborate effectively with cross-functional teams.
- Self-motivated and detail-oriented, with the ability to work independently in a remote setting.
- Commitment to maintaining the highest ethical standards and patient confidentiality.