job description
Join Nezda Technologies as a USRN - Clinical Nurse Auditor or CPC - Coding Denials Auditor and play a pivotal role in ensuring accuracy, compliance, and efficiency in healthcare billing and clinical documentation. This is a remote opportunity based in Bali, Indonesia, offering a competitive salary and the chance to work with a dynamic, globally focused team.
As a Clinical Nurse Auditor, you will review medical records to verify coding accuracy, identify discrepancies, and ensure adherence to regulatory standards. For the Coding Denials Auditor role, you will analyze denied claims, determine root causes, and implement corrective actions to minimize revenue loss. Both positions require a keen eye for detail, deep clinical knowledge, and expertise in medical coding systems (e.g., ICD-10, CPT, HCPCS).
This role is ideal for US-registered nurses (USRN) or Certified Professional Coders (CPC) with a passion for healthcare compliance and process improvement. If you thrive in a fast-paced, detail-oriented environment and want to contribute to high-impact auditing projects, we want to hear from you!
Responsibility
- Conduct comprehensive audits of medical records to ensure accuracy in clinical documentation and coding.
- Identify and resolve discrepancies in billing, coding, and documentation to prevent claim denials.
- Analyze denied claims, determine root causes, and develop strategies to reduce future denials.
- Collaborate with healthcare providers, coders, and billing teams to improve compliance and revenue cycle efficiency.
- Stay updated on evolving healthcare regulations, coding guidelines (ICD-10, CPT, HCPCS), and payer policies.
- Prepare detailed audit reports and recommendations for process improvements.
- Provide training and guidance to clinical and coding staff on best practices for documentation and compliance.
- Ensure adherence to HIPAA, CMS, and other regulatory requirements in all auditing activities.
Qualifications
- Active USRN (US-Registered Nurse) license or CPC (Certified Professional Coder) certification.
- Minimum 2 years of relevant experience in clinical auditing, medical coding, or revenue cycle management.
- In-depth knowledge of ICD-10, CPT, HCPCS, and other medical coding systems.
- Experience with denial management and claim appeals processes.
- Strong analytical skills with the ability to interpret complex medical records and billing data.
- Excellent communication skills to articulate findings and recommendations to stakeholders.
- Proficiency in auditing software and tools (e.g., Epic, Cerner, or other EHR systems).
- Ability to work independently in a remote setting with a high degree of accuracy and attention to detail.